RACHEL MARTIN, HOST:
Health care is a major issue in this election, specifically the protection of coverage for preexisting conditions. Joe Biden says another four years of Trump will jeopardize that protection. Trump says he also wants to protect preexisting conditions. But does that rhetoric match reality? Will Stone reports.
WILL STONE, BYLINE: Since her diagnosis, Noshin Rafieei will have this same nightmare. She's in a cabin with friends and family. And then...
NOSHIN RAFIEEI: I always have these panic attacks like, (gasping), my medicine. Oh, my God, we got to get back. I got to get my medicine.
STONE: There's been a lot of medicine in her life recently. Rafieei teaches sociology at a college in Phoenix in 2016. She was diagnosed with colon cancer at the age of 32. She later learned it had spread to her liver.
RAFIEEI: I was taking oral chemo morning and night. Like, just imagine that's your breakfast, essentially. And your dinner is just rat poison.
STONE: Then there was the radiation.
RAFIEEI: I can't even describe how awful that was. It was a horrible time in my life.
STONE: And this year, she got a liver transplant. Rafieei does have health care coverage through her job, but she still runs into lots of issues. Right now, her insurance is denying a treatment to quell excruciating itching inside her body.
RAFIEEI: I've been hospitalized for it before. I mean, it's just been so bad. I just asked my friend the other day - I said, is it even worth trying to fight this?
STONE: But 10 years ago, before the Affordable Care Act or ACA, insurers could just refuse to cover someone with her medical history. Rafieei says that's why she's voting for Joe Biden, who helped get the ACA passed in the first place.
RAFIEEI: It angers me deep down in my heart. The people that are trying to eliminate the protection for individuals such as myself with preexisting conditions - they must not understand what it's like.
STONE: In six battleground states, including Arizona, voters said preexisting conditions is their top health concern.
RAFIEEI: I can't even believe it's in jeopardy.
STONE: Polling shows a majority of Democrats, independents and Republicans want these protections. The difference is most Republicans also want the ACA struck down.
(SOUNDBITE OF ARCHIVED RECORDING)
PRESIDENT DONALD TRUMP: We'll always protect people with preexisting.
STONE: That's President Trump in the last debate.
(SOUNDBITE OF ARCHIVED RECORDING)
TRUMP: So I'd like to terminate Obamacare, come up with a brand-new, beautiful health care.
STONE: But Republicans already tried that in 2017 under Trump and failed. Still, they've managed to chip away at the law. Now Trump and Republican attorneys general are asking the U.S. Supreme Court to topple the entire law with a hearing set for November 10. Swapna Reddy teaches health policy at Arizona State.
SWAPNA REDDY: Look. If the ACA is repealed at the Supreme Court - at the moment, we have absolutely no national replacement plan.
STONE: If the law goes or even just part of the law, whoever is president will have to clean up the mess. Trump has signed an executive order saying preexisting conditions will be protected, but...
REDDY: It's basically a pinky promise, right? But it doesn't have teeth. What is the enforceability?
STONE: On the campaign trail, Vice President Biden has a similar warning - that no matter what Trump says, he's not doing anything.
(SOUNDBITE OF ARCHIVED RECORDING)
JOE BIDEN: There's no way he can protect preexisting conditions - none, zero. You can't do it in the ether.
STONE: Support for the ACA is at an all-time high. Mark Petersen of UCLA says pushing to get rid of it now...
MARK PETERSON: It's political suicide. There doesn't seem to be any real political advantage anymore at all.
STONE: He says the 2018 midterms show that. Democrats did well running on health care. As for Noshin Rafieei in Arizona, she plans to vote in person even though she's immunocompromised.
RAFIEEI: I'm terrified. It might be a long day. But you know what? I want to fix whatever I can.
STONE: A few days after she votes, she'll get a coronavirus test and go in for another round of surgery.
For NPR News, I'm Will Stone.
MARTIN: That story comes from NPR's partnership with Kaiser Health News. Transcript provided by NPR, Copyright NPR.
