WASHINGTON ― Republican leaders are eyeing last-minute changes to their health care bill in order to attract votes from conservative lawmakers, including removing the requirement that insurance companies cover maternity care for everyone.
Before the Affordable Care Act became law in 2010, the insurance market was a bleak place for women. They often had to pay more than men for the same coverage. Only 12 percent of individual market plans covered maternity care. And it was completely legal for insurance companies to refuse coverage to women who were pregnant or might become pregnant in the future.
One of the ACA’s most celebrated features is that it attempted to fix this gender disparity. It created a list of 10 essential health benefits that all plans on the marketplace must cover. Pregnancy, maternity and newborn care are on that list. It also said that insurance plans must offer contraception at no cost, along with breastfeeding equipment and services.
These features would likely go away if the band of conservatives known as the House Freedom Caucus gets to change the GOP health care bill, the American Health Care Act, in the way that it wants. These lawmakers want to get rid of the 10 essential health benefits, which could lower premiums, and it’s a concession that President Donald Trump has reportedly said he would agree to.
Indeed, the White House has said publicly that it doesn’t like these benefits, citing mandatory maternity care in particular.
“A 54-year-old doesn’t need certain things. They don’t need maternity care,” White House press secretary Sean Spicer said last week. “They don’t need certain medical services that are being provided to them by this government product that is being forced on them right now.”
Democrats are hitting back hard on these potential changes.
“[Eliminating] essential health benefits means Republicans are making being a woman a preexisting condition,” House Minority Leader Nancy Pelosi (D-Calif.) told reporters Thursday. “Again, stripping guaranteed maternity care is a pregnancy tax, pure and simple.”
Republicans have long opposed the idea of making insurance companies cover benefits like maternity care.
In 2009, during the debate over the Affordable Care Act, then-Sen. Jon Kyl (R-Ariz.) argued, “I don’t need maternity care, and so requiring that to be in my insurance policy is something that I don’t need and will make the policy more expensive.”
“I think your mom probably did,” Sen. Debbie Stabenow (D-Mich.) shot back.
More recently, Rep. John Shimkus (R-Ill.) said it wasn’t fair to make men “purchase prenatal care.”
Sen. Pat Roberts (R-Kan.) also seemed skeptical of the whole idea of essential benefits on Thursday.
(For the record, mammograms also test for breast cancer in men.)
The way insurance works is that everyone pays into a system so people are able to get money when they need it. You may never have cancer, but your insurance payments are helping to cover people who will. Women don’t have prostates, but their insurance premiums help fund men’s prostate cancer screenings and treatments.
“We shouldn’t allow insurance companies to say men’s health care is basic health care, but women’s health care is not,” Stabenow recently told The Huffington Post.
Experts also worry that if insurance companies are given the option of offering expensive services like maternity care, it will become a race to the bottom where that coverage, once again, becomes scarce.
And even though nearly half of pregnancies in the United States are unplanned, women would have to purchase this maternity coverage months in advance of being pregnant ― otherwise it could be considered a preexisting condition for which insurance companies could deny coverage.
Want more updates from Amanda Terkel? Sign up for her newsletter, Piping Hot Truth, here.