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AHCA round 2: The issue of essential health benefits

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AHCA round 2: The issue of essential health benefits

Just when you thought that the Republicans in Congress had had enough of President Donald Trump’s American Health Care Act (or AHCA), it’s now back in the limelight again with amendments supposed to deal with its flaws.

However, one of the controversial issues surrounding the new AHCA (or its version 2) now at the House is the supposed removal of essential health benefits pertaining to pre-existing conditions.

The issue with AHCA version two

Currently under the Affordable Care Act (ACA), suppliers of insurance are required to cover 10 essential health benefits, ranging from mental health and substance abuse services to pregnancy and newborn care.

Though Republican lawmakers wanted them removed in the previous incarnation of the AHCA, under the new version of the AHCA, these will still remain– but these will be left up to the states, to keep them or to waive them.

The particular amendment was pushed by Republican Rep. Tom MacArthur of New Jersey, who gave states the power to opt out of “essential health benefit” requirements and instead use their own requirements.

This, of course, is where it becomes problematic: without these requirements, the new healthcare bill strips the protections for people with pre-existing health conditions.

This is because with the aforementioned waiver, health insurers aren’t required to offer the same price for these essential health benefits to people with particular health issues– leading to more expensive healthcare for them.

Those affected by the AHCA version two

Unfortunately, one segment that would be terribly hit by these possible waivers are women, making the new healthcare bill discriminating against them– despite claims of being non-discriminatory.

This is because a lot of the essential benefits cover those that women need, like for pregnancy, maternity, newborn care, birth control, and breastfeeding.

“The MacArthur amendment just makes things kind of worse,” Dr. Diane Horvath-Cosper, an Advocacy Fellow at Physicians for Reproductive Health, told ELLE.com.

“If a state decides to not include maternity care as an essential benefit, a majority of people who get pregnant identify as women, so that’s gender discrimination, straight up,” says Dr. Horvath-Cosper.

Congress to vote on AHCA version two

What makes the situation worse is that the new version of the AHCA is being pushed– but this time without the assessment of the Congressional Budget Office (CBO).

The non-partisan CBO had earlier given their analysis of Trump’s healthcare program, citing its flaws and its costs. But this time, the Republican majority in Congress isn’t waiting for the assessment.

As Sarah Kliff of Vox writes, the Republicans “risk setting themselves up for embarrassment when the numbers actually do come out and don’t look good.”

Let’s see what will happen on Thursday when Congress votes on the AHCA.

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