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By Shefali Luthra January 15, 2020

Trump’s claim that he ‘saved’ pre-ex conditions ‘part fantasy, part delusion’

President Donald Trump attempted to take credit for one of the most popular elements of the Affordable Care Act: Its protection for people who have preexisting medical conditions.

"I was the person who saved Pre-Existing Conditions in your healthcare," Trump tweeted on Jan. 13.

The  protection for people with medical problems has been a rallying cry for Democrats, and they used the issue to help propel their widespread election victories in 2018.

Trump repeatedly has sought to align himself with this issue – in May, for instance, claiming he would "always protect patients with preexisting conditions." We rated that claim False. His re-election campaign has made similar claims, which experts debunked.

Trump’s recent claim that he "saved" that guarantee of coverage adds a new twist, though. We contacted the White House to find out the basis for this statement.

Judd Deere, a White House spokesman, told us, "President Trump has repeatedly stated his commitment to protect individuals with preexisting conditions and his track record shows that he has consistently done what is necessary to improve care for the vulnerable." Deere also pointed us to a range of other policy initiatives – such as efforts on kidney health, approving generic drugs and loosening restrictions on short-term health plans.

But none of those addressed the basis of Trump’s tweet.

The health policy experts we consulted, however, were unambiguous: The president’s claim has no factual basis and flies in the face of his ongoing policy efforts.

"I feel like we’re being gas-lit," said Linda Blumberg, a health economist at the Urban Institute. "You can’t tell me you’re the savior of people with preexisting conditions when every single thing you’ve said or done is the opposite of that." (Gaslighting means manipulating the telling of events in such a way it leads people to question their recollections.)

This skepticism persisted across the political spectrum.

"That’s a rather extended version of aspirational rhetoric short of any evidence," said Tom Miller, a resident fellow at the conservative American Enterprise Institute.

The preexisting condition protection

Under the Affordable Care Act, or ACA, health insurance plans cannot charge people higher prices because they have a medical condition. This protection has been intact since the law took effect, under then-President Barack Obama.

As a 2016 candidate, Trump promised to repeal and replace the health law. That came to a head in 2017, when the law came within one vote in the Senate of being undone.  

"That tweet is part fantasy, part delusion, part politics, and all lie," said Jonathan Oberlander, a health policy professor at the University of North Carolina-Chapel Hill. "The president is lying about preexisting conditions. He supported, and continues to support, efforts to repeal the ACA that would take those consumer protections away."

After that effort, Blumberg said, the president boasted that he had dismantled Obamacare – which is not only untrue, but, she added, confused many consumers.