DD linked to this in today’s open thread, and I’m going to break it down. It’s no secret that Trumpcare may not pass the House today. If it does, it’s in large part due to a deal with conservatives to strip the essential health care requirements from insurance. You know, the parts of insurance that actually cover health care.
Here’s a list of the essential health care requirements that will be eliminated:
• Outpatient care without a hospital admission, known as ambulatory patient services
• Emergency services
• Pregnancy, maternity, and newborn care
• Mental health and substance use disorder services, including counseling and psychotherapy
• Prescription drugs
• Rehabilitative and habilitative services and devices, which help people with injuries and disabilities to recover
• Laboratory services
• Preventive care, wellness services, and chronic disease management
• Pediatric services, including oral and vision care for children
Outpatient care without a hospital admission, known as ambulatory patient services
What is ambulatory care and what does it include?
Any health care you can get without staying in the hospital is ambulatory care. That includes diagnostic tests, treatments, or rehab visits.
You may get ambulatory care in:
Ambulatory surgery center
Outpatient hospital department
These are some, but not all, types of ambulatory care:
Minor surgical procedures
Ambulatory care is one of the essential health benefits. Those are the benefits all health plans must cover to be sold in a state Marketplace, which is also called an Exchange.
That’s quite a list. It’s also a list of services that most everyone uses. One of the main things the ACA accomplished was defining what could be called health insurance. We get this in every other aspect of our lives. It’s why you can’t wrap ground beef in brown paper and sell it as filet mignon (Don’t worry. I’m sure that’s coming).
So now… unless a hospital admits you (and you had better make sure they formally admit you) your chemo, radiation, colonoscopy, blood tests, etc. don’t have to be covered. Welcome back, junk insurance!
Emergency services and Hospitalization
The biggest reason to have health insurance is for emergencies that often end up with hospitalization. Who would buy a plan that didn’t cover these basic elements? Answer: Desperate people who will soon find themselves in the good old days of medical bankruptcy. The GOP loves it some junk insurance – and they’ll love blaming these people for buying it – never mentioning how they couldn’t afford the better plan. Or they’ll ask if they own an iPhone.
Pregnancy, maternity, and newborn care
So much for all that “pro-life” and “family values” talk. Always, always, look at what Republicans do, not what they say. Some of them act affronted at Donald Trump’s lying, but he fits right in with this crew.
Republicans love to point out how it isn’t fair to ask men to pay for pregnancy and maternity coverage (it’s like pregnancy is something men have no role in), but it’s interesting how they’ve cut off care for newborns. For years, I’ve had push back whenever I’ve said Republicans only care about fetuses and couldn’t care less about the born. Thanks for proving me right, guys!
And their plans for women get even uglier:
The worst provision in the manager’s amendment is a Medicaid work requirement that would allow states to revoke Medicaid coverage from new mothers who haven’t found a job within two months after giving birth.
Two months after giving birth. Better start pounding that pavement, ladies. This from a party that waxes lyrical about women staying home with their children. Add that to the list of their lies. Of course, it defunds Planned Parenthood, too! So, for many women (and men), even if you have insurance you won’t have access to care.
Mental health and substance use disorder services, including counseling and psychotherapy
It’s interesting how every time there’s a shooting, Republicans play the lone wolf, mental illness card. You’d think they’d support covering mental health, but they don’t. More talk. And given that their base states/supporters are disproportionately impacted by addiction, especially meth, you’d think they’d be concerned. They aren’t.
Really? Only someone who has never paid full price for their prescriptions would be okay with this. Actually, only people who have received excellent health benefits (Hello, Congress!) could be this out of touch. All of these proposed eliminations show that it isn’t only Trump who didn’t know insurance could be so complicated. It also explains why Republicans are stunned by their constituents response at recent town halls. Only people in a bubble, who never had to worry about the cost of health insurance and prescription drugs, are surprised by the push back.
Rehabilitative and habilitative services and devices, which help people with injuries and disabilities to recover
Know a good way to lower costs? Make sure people make progress so they don’t end up worse off and needing more health services. If the GOP plan is about cost savings (it isn’t) then rehabilitative and habilitative services and devices will save a lot of money. So… you get hip replacement surgery, but don’t receive rehabilitation and then end up in a wheelchair? Will the wheelchair be covered? I just cracked myself up.
Need blood tests, urine tests, etc.? They’re so extra. I’m sure the labs will accept Mastercard and VISA. Or you can just skip it and hope you get sick enough to qualify for care. That’s pretty much the GOP’s entire plan. If you die quickly, that’s a bonus!
Preventive care, wellness services, and chronic disease management
Under the Republican plan you may qualify for care if you’re at death’s door. Again, this isn’t a way to cut costs. (see paragraph above. You know what to do.)
Pediatric services, including oral and vision care for children
This one is stunning, but it ties in with eliminating pregnancy, maternity and newborn care. This just extends no care for newborns to children. Family values, my ass. Eliminating care for pregnancy, maternity, newborns and children shows you exactly what the GOP thinks of these groups.
Show me your health care plan and I’ll show you your values. And the idea that eliminating these health requirements made the AHCA more appealing to conservatives, and that Trump and other republicans were willing to put them on offer because… why not? displays their disdain for the most vulnerable among us. They really seem to despise the poor, the elderly, women and children who will be devastated by their plan.
One more thing… If you think, for one second, that eliminating these essential health requirements won’t affect you, you’re kidding yourself. A la carte insurance is heading your way. No one thinks businesses and insurance companies won’t latch onto this to save money, do they? Can you imagine what sort of company insurance will be offered in a male dominated business? I can.
If the AHCA, somehow, becomes law then we are looking at more junk insurance, more medical bankruptcy, and more people dying. That is the GOP plan.