\n\tJacob Gardenswartz<\/span><\/p>\n

If the Affordable Care Act were terminated, \u201cthat would mean over a hundred million Americans will lose protections for preexisting conditions.\u201d<\/p>\n

President Joe Biden in a campaign advertisement, May 8<\/p>\n

President Joe Biden\u2019s reelection campaign wants voters to contrast his record on health care policy with his predecessor\u2019s. In May, Biden\u2019s campaign began airing a monthlong, $14 million ad campaign targeting swing-state voters and minority groups with spots on TV, digital, and radio.<\/p>\n

In the ad, titled \u201cTerminate<\/a>,\u201d Biden assails former President Donald Trump for his past promises to overturn the Affordable Care Act, also known as Obamacare. Biden also warns of the potential effect if Trump is returned to office and again pursues repeal.<\/p>\n

\u201cThat would mean over a hundred million Americans will lose protections for preexisting conditions,\u201d Biden said in the ad.<\/p>\n

Less than six months from Election Day, polls show<\/a> Trump narrowly leading Biden in a head-to-head race in most swing states. And voters trust Trump to better handle issues such as inflation, crime, and the economy by significant margins.<\/p>\n

An ABC News\/Ipsos poll<\/a> of about 2,200 adults, released in early May, shows the only major policy issues on which Biden received higher marks than Trump were health care and abortion access. It\u2019s no surprise, then, that the campaign is making those topics central<\/a> to Biden\u2019s pitch to voters.<\/p>\n

As such, we dug into the facts surrounding Biden\u2019s claim.<\/p>\n

Preexisting Condition Calculations<\/strong><\/p>\n

The idea that 100 million Americans are living with one or more preexisting conditions is not new. It was the subject of a back-and-forth between then-candidate Biden and then-President Trump during their previous race, in 2020. After Biden cited that statistic in a presidential debate<\/a>, Trump responded, \u201cThere aren\u2019t a hundred million people with preexisting conditions.\u201d<\/p>\n

A KFF Health News\/PolitiFact HealthCheck<\/a> at the time rated Biden\u2019s claim to be \u201cmostly true,\u201d finding a fairly large range of estimates \u2014 from 54 million to 135 million \u2014 of the number of Americans with preexisting conditions. Estimates on the lower end tend to consider \u201cpreexisting conditions\u201d to be more severe chronic conditions such as cancer or cystic fibrosis. Estimates at the spectrum\u2019s higher end include people with more common health problems such as asthma and obesity, and behavioral health disorders such as substance use disorder or depression.<\/p>\n

Biden\u2019s May ad focuses on how many people would be vulnerable if protections for people with preexisting conditions were lost. This is a matter of some debate. To understand it, we need to break down the protections put in place by the ACA, and those that exist separately.<\/p>\n

Before and After<\/strong><\/p>\n

Before the ACA\u2019s preexisting condition protections took effect in 2014, insurers in the individual market<\/a> \u2014 people buying coverage for themselves or their families \u2014 could charge higher premiums to people with particular conditions, restrict coverage of specific procedures or medications, set annual and lifetime coverage limits on benefits, or deny people coverage.<\/p>\n

\u201cThere were a number of practices used by insurance companies to essentially protect themselves from the costs associated with people who have preexisting conditions,\u201d said Sabrina Corlette<\/a>, a co-director of the Center on Health Insurance Reforms at Georgetown University and an expert on the health insurance marketplace.<\/p>\n