WASHINGTON -- Mitt Romney's pledge to guarantee access to health insurance for people with longstanding medical problems highlighted the difficulty of repealing the new health care law while keeping some of its popular features.

"I'm not getting rid of all of health care reform," Romney said over the weekend on NBC's "Meet the Press." "Of course, there are a number of things that I like in health care reform that I'm going to put in place. One is to make sure that those with pre-existing conditions can get coverage."

Romney did not explain a significant feature of his proposal: He would explicitly guarantee insurance for people with existing conditions only if they have maintained coverage without a significant gap.

That could exclude millions of Americans with medical problems like cancer, heart disease and asthma.

This qualification was clear in a statement Romney issued in March, when he called for repeal of the 2010 law and presented his own vision for health care. Romney said then that he would "prevent discrimination against individuals with pre-existing conditions who maintain continuous coverage." Thus, aides to Romney said, he was not breaking new ground with his comments over the weekend.

Brad Woodhouse, a spokesman for the Democratic National Committee, said Monday, Sept. 10, that Romney's comments were misleading because they left an impression that he supported protections for people with existing conditions like those in President Barack

And what about people with medical problems who have never had health insurance or have had a gap in coverage for months or years?

Breaks in coverage are common. A recent report by the Commonwealth Fund found that 89 million Americans went without health insurance for at least one month in the period from 2004 to 2007, perhaps because they had lost jobs, been divorced or lost eligibility for a public insurance program. Of those, 23 million saw their insurance lapse more than once in the four-year period.

Romney says many of them could obtain coverage through health plans known as high-risk pools. Many states have such pools, which generally operate at a loss. And the federal government is running a high-risk pool, as a temporary measure under the new health care law, in more than 20 states.

Romney has not said whether or how he would regulate premiums or subsidize the costs of coverage in a high-risk pool.

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Romney's pledge shows repealing health law complex