"In reality, is any governor, is any state legislature, going to deny coverage based on preexisting condition?" Flake, a supporter of the bill, said when pressed.
"Yes," host Joe Scarborough answered.
"I don't believe they will," Flake replied.
"Yes, yes, they are," Scarborough shot back.
"In the past, maybe, but not anymore," Flake said. "I don't believe that's the case. They have to respond to political pressure, just like us. You can say right now that this is not a constitutional guarantee for preexisting condition coverage, therefore, Congress could, at a whim, at any moment, deny the coverage. That could be said now, but Congress is not going to."
The Graham-Cassidy bill, however, would also let states waive several key Obamacare protections for those with pre-existing conditions. While it would still require insurers to provide coverage to everyone, states could allow carriers to charge enrollees more based on their medical history. As a result, younger, healthier folks could see their premiums go down, but sicker Americans could find themselves priced out of policies.
The legislation also would let states eliminate Obamacare's essential health benefits provision, which mandates insurers cover an array of services, including hospitalization, maternity care, prescription drugs, mental health and substance abuse services. This could lower premiums somewhat and give consumers a wider choice of plans. But it would also make it harder for people to buy comprehensive policies, so those with pre-existing conditions might not be able to find coverage that meets their health care needs.
Flake's effort to reassure people with preexisting conditions rests on the assumption that political pressure will convince governors to maintain coverage protections.
But those protections are already law. That was a key plank of the Affordable Care Act -- preventing insurers from denying coverage for preexisting conditions, or charging more for that insurance.
Nevertheless, Flake compared the current health care debate to the debate over welfare reform in the 1980s, and said he wasn't concerned about a "race to the bottom" for insurance coverage.
"In 1986 with welfare reform, it was said, all right, you turn this over to the states, it's going to be a race to the bottom -- people will be lying on grates, dying in the streets. It wasn't the case. Because [state officials] respond to political pressure as well."
Vice President Mike Pence was also asked about pre-existing conditions in an interview on Fox Thursday morning and argued governors are better suited to make decisions for their individual state.
"Can you guarantee that these governors will make sure preexisting conditions are covered?" host Ainsley Earhardt asked.
Pence answered, "Thomas Jefferson said the government that governs least governs best. The question that people ought to ask is, who do you think will be more responsive to the health care needs in your community? Your governor and your state legislator or a congressman and a president in far off nation's capital? This is the concept of federalism upon which our Constitution was framed."