Republicans will totally protect people with Pre-Existing Conditions, Democrats will not!” President Trump tweeted on Wednesday. “Vote Republican.”

The issue of making sure that those with pre-existing medical conditions can obtain coverage has become a central part of the 2018 midterm elections. Democrats have seized on Republican efforts to repeal Obamacare and a pending lawsuit to argue that, if Republicans get their way, Americans with pre-existing conditions will lose coverage. In turn, Republicans led by Trump have vowed to protect people with pre-existing conditions.

The denial of coverage to those with pre-existing conditions was one of the leading critiques of the pre-Obamacare market, and the elimination of the practice has consistently been the most popular part of the law.

The issue is particularly challenging for those who support free-market healthcare solutions. Given that in a pure market, it would only make sense for insurers to cover those who they could make money off of, there is a legitimate question about what happens to those those with higher medical costs who insurers would be inclined to either deny coverage or only offer coverage at sky-high rates.

But this problem, while very significant to real people, is not as widespread as is being presented. This reality has important implications for the way that the issue should be managed. There are better ways to address the issue than the system that exists under Obamacare, in which the desire to protect those with pre-existing conditions has distorted the market, reduced choice, and made health insurance unaffordable for millions of Americans.

The Houston Chronicle reported, “More than 100 million people in this country have a pre-existing medical condition that could make finding health coverage difficult, if not impossible, should current protections be lifted, a national study released has found.”

The story was based on a new study from Avalere that determined that elimination of the requirement forcing insurers to cover those with pre-existing conditions at the same price as healthy individuals would put 102 million Americans at risk.

The 100 million number is highly misleading. The figure represents the number of people who, in theory, could have trouble finding health insurance if they go uninsured because of some sort of medical condition if Obamacare were repealed. But an overwhelming majority of those people already have coverage through their employers and, even before Obamacare, would qualify for COBRA coverage for 18 months after losing or changing jobs. While there may be instances in which individuals have such debilitating illnesses that they couldn’t work again, that won’t be the case for the overwhelming majority. The tens of millions of people who have diabetes or high blood pressure or high cholesterol are not somehow unemployable in perpetuity.

Put another way, just because somebody has a condition that is theoretically declinable, it doesn’t mean that person was ever or will ever actually be declined — or consistently uninsured. In the pre-Obamacare market, people being denied coverage due to pre-existing conditions was a problem, but it did not affect anywhere near 100 million people in practice.

Just before losing control of the House in 2010, Democrats on the Energy and Commerce Committee released a report attempting to highlight the problems faced by those with pre-existing conditions before Obamacare passed. Democrats looked at information from four leading insurers, Aetna, Humana, UnitedHealth Group, and WellPoint, and found that in 2009 — the year before the passage of Obamacare — 257,100 were denied coverage.

That year, those four insurers covered 2.8 million people, which, according to an analysis of data from the Kaiser Family Foundation, would have represented about one-fifth of the 13.7-million-person individual market. If other insurers discriminated at the same rate, it would suggest the number of people being denied was just over a million — if other insurers discriminated at a higher rate, perhaps it was several million. This would be consistent with a Kaiser finding that before Obamacare, 18 percent of applicants in the individual insurance market were denied coverage, or roughly 1 percent of the U.S. population.

Now, it’s true that these numbers don’t include people who didn’t even bother applying for coverage because they assumed they’d get denied or those who were accepted at prices they couldn't afford. That having been said, the fact that just about 9 million people enroll in Obamacare each year is further evidence that the demand for individual market coverage for those with pre-existing conditions is relatively small — especially given that they only represent a portion of that 9 million.

A few million people being denied coverage is a problem, but it is a far cry from the scary headlines of 100 million people with health insurance being at risk under a repeal scenario.

Now, if, as a society, we decide that it’s too precarious to have people with prior medical issues facing the prospect of being uninsured if they lose their jobs, it would make the most sense to find a targeted solution that addressed the needs of this specific population. You could, for instance, directly subsidize insurance for those who suffer from conditions that make them uninsurable in a pure market. This would spread the cost of covering pre-existing conditions among all taxpayers and provide space for reforms that would bring more choices and lower costs to the rest of the public.

Instead of doing things this way, Obamacare imposed a complex tax and regulatory regime on the whole country that stifled choice and drove up prices. Rather than have the cost shared by hundreds of millions of taxpayers, Obamacare concentrates the pain on a few million Americans seeking coverage on the individual market who have dealt with several years of skyrocketing premiums and restricted access as insurers look for ways to offset the cost of covering those with higher medical expenses.

This is a debate that Republicans can and should win. Americans want to cover those with pre-existing conditions, but they also want a functional health insurance market with more choice. It’s possible to accomplish both. But unfortunately, Republicans are running scared and have decided that it’s easier to just embrace Obamacare.