WASHINGTON — As Republicans confront the thorny realities of repealing and replacing the Affordable Care Act, groups representing patients with the most serious diseases fear those plans could return the US health care system to one in which sick people are not guaranteed health insurance.
It comes down to the individual mandate, the law’s most unpopular provision, which required every American to buy insurance or face a penalty.
Republicans want it gone. But if they nix the mandate, it becomes exceedingly difficult to keep the popular insurance reforms — including the requirement that health plans cover everybody, even people with costly preexisting conditions, without charging those people more. President Trump and other Republicans have sworn they would keep that provision, which ended discrimination against America’s sickest patients.
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