Romney does have a plan for pre-existing conditions. Here’s how it works — and how it doesn’t.

September 9, 2012

On "Meet the Press" this morning, Mitt Romney offered an endorsement for parts of the health reform law that he does like.

"Of course there are a number of things I like about health-care reform that I'm going to put in place," he said. "One is to make sure those with pre-existing conditions can get coverage."

This isn't the first time that Romney has endorsed that position: Back when the Supreme Court was about to issue its decision on Obamacare, his spokeswoman Andrea Saul laid out a few more of the policy points.

Andrea Saul confirmed that the former governor does not support the across-the-board consumer protections for pre-existing conditions as written into Democrats’ health care law.

“Governor Romney supports reforms to protect those with pre-existing conditions from being denied access to a health plan while they have continuous coverage,” she said first in a statement to the Huffington Post later obtained by ABC News.

It makes sense, politically, to support the end of pre-existing conditions: It regularly polls as one of the health-care law's most popular provisions.

Policy-wise, however, there's a significant amount of space between "ending pre-existing conditions" and "ending pre-existing conditions [with continuous coverage]." Under the former scheme, insurers cannot deny coverage to an individual -- no matter what. Under the latter, insurers can, in certain situations, refuse to cover some individuals.

The idea of "continuous coverage" is pretty much what it sounds like: Under the scheme Saul laid out earlier, an individual who kept buying insurance month after month could not be turned away by an insurance company. The goal is to create an incentive for healthy people, who don't think they really need coverage, to keep paying monthly premiums -- ensuring that they would have access to health insurance if their health should take a turn for the worse.

Congress thought it was a good enough idea to make a whole law out of it. The 1996 Health Insurance Portability and Accountability Act greatly limited the ability of group plans to exclude employees' pre-existing conditions if they had continuous coverage prior to the new job.

That's great for an individual who gets a new job. But continuous coverage isn't so great for the individual who has spent sometime without insurance, perhaps because of difficult financial times. Continuous coverage won't do much for you in that situation.

That's different from the health-care law, which stipulates that in 2014, anyone can gain access to health coverage regardless of his or her prior insured status. If Romney wanted to keep that kind of protection against pre-existing insurance in place -- but without an individual mandate -- insurance premiums would likely increase, as the sick people who planned to use their coverage disproportionately signed up.

Continuous coverage is one way to address pre-existing conditions; Congress has already used it as a tool to limit group health plans that deny such coverage. But, with the many people it has the potential to leave out, it's hard to see it as a full solution.

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