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Health is a basic human right. Unlike an abstract concept like freedom, however, the delivery of health care is a maddeningly complex and expensive undertaking.

Do you have the right to be healthy? Yes, of course. Do you have the right to receive immunizations, see a doctor or undergo preventative tests like mammograms or colonoscopies?

Yes, but that level of specificity belongs in the realm of insurance regulations, or maybe statute, instead of a Missouri Constitution that’s approaching a big-city phone book in terms of heft. Did Missouri need medical marijuana in its Constitution? Probably not, but lawmakers refused to act and voters felt strongly about it, so there you are.

Pre-existing conditions are a different matter. This issue is broad enough that it potentially affects all Missourians. In fact, one of the more popular provisions of the Affordable Care Act protects Americans from the denial of health coverage on the basis of a pre-existing condition like high blood pressure, diabetes or cancer.

It’s not an abstract issue. In 2019, the Kaiser Family Foundation estimated that more than 1 million Missourians between the ages of 18 and 64 had some sort of pre-existing condition that could have led to disqualification from insurance coverage. That’s about 30% of the state’s non-elderly population.

Since its inception, the ACA has withstood more than a decade of congressional and legal challenges. In June, the U.S. Supreme Court is expected to rule on a current lawsuit from a coalition of states, including Missouri.

The prospect of the court striking down the ACA might leave lawmakers, including some Republicans, contemplating a “be-careful-what-you-wish-for” scenario. State Rep. Brenda Shields, R-St. Joseph, is among a handful of Republicans proposing constitutional amendments that would prohibit insurers from denying coverage or charging extra on a basis of a person’s pre-existing condition.

As a former chief executive of the United Way, Shields is aware of the struggles that low-income families face in our area. Her own experience with a severe bout of COVID-19 may have added an extra layer of understanding of how a seemingly healthy person’s life can change with a single diagnosis.

If approved in this year’s legislative session, House Joint Resolution 51 would go to a statewide vote to determine if the Missouri Constitution should include insurance protections for those with pre-existing conditions. It’s a measure that shouldn’t get tied up in an emotional and politicized debate about the ACA.

Voters deserve a chance to decide on this important consumer protection.

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