The battle over coverage for pre-existing conditions has become a central front in the 2018 midterm elections, but however heated their rhetoric and whatever their positions have been in the past, there is operatively no difference between Republicans and Democrats on the issue.

What I mean by that is no matter who controls Congress at the end of this process, Obamacare's ban on allowing insurers to deny coverage to those with pre-existing conditions is going to remain intact.

There are two basic reasons why Democrats have argued that Republicans are gearing up to gut rules governing those with pre-existing conditions. One is Republican talk of reviving the effort to repeal Obamacare if they maintain control of Congress. The second is the pending lawsuit, that if successful, could wipe out those regulations.

In practice, however, nothing is going to change. And I say this as somebody who wants very much for things to change. As I have written recently, I think the issue is being overblown and requires a more targeted solution. I also think Republicans' embrace of Obamacare's approach to pre-existing conditions is a mistake that will come back to haunt them.

The reality is that whatever statements Senate Majority Leader Mitch McConnell, R-Ky., may make, he lacks the votes to repeal Obamacare in general, and specifically the pre-existing condition regulations.

Most of those who understand Senate procedure believe that it would require at least 60 votes to get rid of the pre-existing condition coverage requirement, because it is a regulation and not a tax or spending element that would be clearly budgetary (and thus open up the ability to pass legislation by a simple majority through reconciliation).

Republicans could not even muster 50 votes in the Senate to pass a watered-down partial repeal Obamacare in 2017, coming off an election in which they swept the House, Senate, and White House and had been running on full repeal for four straight election cycles. They certainly aren't going to have any votes in 2019, and this is particularly true of the pre-existing conditions requirement, because several Republican senate candidates in tough races have been running on pledges to leave those protections intact.

And, remember, to pass anything with a simple 50 votes (with Vice President Mike Pence as a tie-breaker), they would either have to nuke the legislative filibuster and/or aggressively use reconciliation. The fact is that repealing pre-existing condition requirements would not only mean that candidates who pledged to keep the regulations intact would have to reverse course, but it would mean they'd have to support blowing up Senate rules to do so. Even then, it would have to be signed by President Trump ahead of his reelection, as he's going around the country from rally to rally vowing to protect those with pre-existing conditions.

As far as the lawsuit, there is very little reason to believe that the long-shot lawsuit, which is currently stuck at the lower court level, would succeed. Even if it made it all the way up to the Supreme Court, it would require Chief Justice John Roberts, who has twice sided with liberals on major Obamacare cases, to switch sides and strike down Obamacare using the weakest challenge yet — one that's even dismissed by a number of Obamacare opponents. Such a decision would have to be made, even though striking it down would cause much more disruption than when the individual mandate case was decided in 2012, when much of the law had not been implemented yet.

So, as much as I'd like for Republicans to articulate an alternate vision for healthcare, they are endorsing Obamacare by default.