I see a difference.
We don't want people with existing conditions to be uninsurable, but we want it to be insurance...if someone only signs up for "insurance" when they have a need, then that's not "insurance." Employer provided health insurance is regulated by federal law. If you change jobs, pre existing conditions are not an issue.
I would be willing to concede that, for continuous coverage, pre-existing conditions should be covered.
If there is a gap, pre existing conditions should NOT be covered.
Fair enough?
When I changed insurance companies in 2002, I got a letter from my soon-to-be previous insurance company stating that I had been continuously insured and therefore no pre-existing condition exclusion applied to my new insurance policy.
I did get the new coverage before I dropped the old (which was COBRA) and bought an individual policy.