Romney's plan covers preexisting conditions - for the rich and the lucky

"You shouldn't have let his health insurance lapse."

For just a moment I thought Romney was actually moving toward the middle. On Sunday's Meet the Press he said he wouldn't get rid of all health-care reform. One thing he planned to do, he said, "is to make sure that those with preexisting conditions can get coverage.”

And then later, of course, his campaign clarified: He would make sure that those with preexisting conditions would be covered if they had continuous insurance coverage. In other words, he would continue to enforce the Health Insurance Portability and Accountability Act of 1996. Well, whew.

Yesterday Washington Post blogger Ezra Klein asked, "Who would be left out of Romney’s preexisting conditions plan?" Answer: "About 89 million Americans."

If you have a pre-existing condition, are covered by a good insurance policy, and qualify for and can afford a COBRA policy, you'll be OK for 18 to 36 months. After that you're on your own.

But people buy COBRA policies because they are out of work, and COBRA's rates are steep for the unemployed: about $500/month for an individual and nearly $1400/month for a family.*

If you have a preexisting condition and can't  afford COBRA, you could lose or be unable to get health coverage under Romney's plan:

• if you're the nonemployed wife or child of a man who retires or dies or loses his job
• if you stop working for several months to care for an aging parent or an ill family member
• if you lose your job due to serious illness or injury
• if you are unemployable due to mental or physical disabilities
• if you take an unpaid maternity leave
• if you're looking for your first job and you are not covered by your parents' insurance
• if your company decides to stop offering a health-insurance benefit
• if the only company who will hire you does not offer a health-insurance benefit
• if your company goes out of business, and it takes you longer than 63 days to find a new job

I understand why preexisting conditions must be tied to continuous insurance coverage: you can't have people signing up for insurance only after they've had the diagnosis or the accident. And indeed, preexisting conditions are tied to continuous insurance coverage in Obamacare (to use the Republicans' preferred term), in socialized medicine (to use another term they favor, even though they usually use it erroneously), and in those developed nations who finance health care through private insurers.

The difference between Romneycare and all those other plans is this: With the other plans, everybody has continuous insurance coverage. With Romneycare, you can have continuous insurance coverage if you can personally afford it, if you are able to work, and if you're lucky.

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*In 2010 an individual policy cost $429 a month and a family policy cost $1170. Those are the latest figures from the Kaiser Foundation; since health-care insurance rates have been rising between 8 and 9% a year for several years, it is reasonable to assume that the average Cobra policy now costs about $505 (individual) or $1377 (family) per month.