One of the most widely repeated myths in health policy is the idea that Obamacare is protecting people with pre-existing conditions.

Many people—maybe even most—who enter the individual market with a serious health problem face worse options today than they did before there was Obamacare.

Under the old system, people could enroll in an individual insurance plan at any time during the year. If they were denied coverage because of their health status, in most states they could obtain coverage through a risk pool—where the insurance was typically a standard Blue Cross plan. The premium was higher, but the deductible was reasonable and they had access to almost any doctor and any hospital.

In the Obamacare exchanges today, by contrast, the premium has doubled, the deductibles are triple what they are in a typical employer plan and narrow networks often exclude the best doctors and the best hospitals. Moreover, an individual is able to obtain insurance only during a six-week open enrollment period and even then, the coverage does not commence until the next January.

What can be done to give real protection to people with pre-existing conditions? Here are some suggestions for the Trump administration and for Congress.

Continuous open enrollment. People who have been continuously insured in the group market should have immediate access to individual insurance when they leave their group plan. They should not have to wait until the next two-month open enrollment period. Also, people who are being mistreated or underserved by their current plan should be able to switch plans at any time.