The pre-existing condition that matters most is poverty or near-poverty

I've made this point before, but here it is again in USA Today:

...in our distorted political combat, "pre-existing conditions" is standing in for "access to affordable health insurance." The real crux of the Republican assault on the ACA last year was shrinking support for the poor and near-poor. The ACA repeal bill that passed the House in May 2017 would have rolled back the Medicaid expansion, reducing Medicaid enrollment by 14 million, according to the Congressional Budget Office. It would have slow-strangled federal funding for all Medicaid programs, which cover 75 million Americans. It would have eliminated the Cost Sharing Reduction subsidies that make coverage affordable for more than 5 million enrollees in the ACA marketplaces, raising their deductibles by thousands of dollars.

I hope you'll read the whole thing. It's got a compressed snapshot of the impact of Medicaid expansion in four poor southern states.

P.S. The USAT headline foregrounded what I regarded as a kind of grudging subtext: "Republicans hand Democrats an election-year gift on health care and it's a winner." My main point is the one made above.  But maybe that's okay. The piece does end with a "so be it."