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April 17, 2017
By Janis Lambert Connallon
In March, the Republicans attempted to restructure Medicaid and repeal funding for the Affordable Care Act (ACA) through their American Health Care Act (AHCA). However, the bill was pulled before a floor vote in the House of Representatives. Now, rumors swirl in Washington about a new version of the health care bill. Revisions of the bill could be even worse for children and families because it will likely include repealing popular protections in the ACA, in order to appeal to more conservative members of the Freedom Caucus.
In the rush to a vote at the end of March, Speaker Paul Ryan tried to craft a bill that would appeal to both the moderate and right wings of the Republican Caucus. He and other Republicans slipped in something that could change the health care marketplace for all of us: a repeal of the Essential Health Benefits (EHBs). The EHBs are 10 benefits that must be offered in individual and small group health plans. These benefits include: ambulatory patient services (outpatient care), emergency services, hospitalization (inpatient care), maternity and newborn care, mental health services, prescription drugs, rehabilitative services, laboratory services, preventative care, and pediatric services, including oral and vision care. Before the ACA, insurers routinely left out access to many of these medical services.
In addition to the EHBs, the most popular ACA provisions are the lifetime caps on health care spending, continued coverage of young adults under their parents’ health plans up to age 26 and protection from insurance discrimination based on pre-existing conditions. Also families are saving tons of money due to the provision making well-child checks free. All of these are at risk with any resuscitated Republican health reform bill. But can we really call health plans without these essential services health insurance?
Many ACA protections are popular even among Republicans. Eighty-three percent of Americans, according to a Kaiser Family Foundation poll in November 2016, support not paying out-of-pocket for prevention, including 77 percent of Republicans. The poll also noted that 69 percent of Americans support access to health care coverage regardless of preexisting conditions, with support from 63 percent of Republicans. Approximately 133 million people are at risk for denied insurance if the preexisting condition provision is repealed. Additionally, more than 100 million people, including children with special health care needs are at risk for maxing out lifetime caps on insurance.
Conservative policymakers oppose even the most popular aspects of the ACA because of federal costs and their ideological belief that the market should regulate itself by weeding out poor performing health plans without government intervention or regulation. Prior to his election, then President-elect Trump told us all that the Affordable Care Act would be replaced in the first 100 days, if not the first day he was in office, with something “for everyone.” Despite these strong philosophical differences and opposition, the ACA repeal has not happened. Most Americans support consumer protections in the ACA and advocates across the country through their town halls and public forums played a significant role in derailing the vote last month. But the threat still remains. All of us who need and support true health care protections and services for children and families must stay vigilant and loud so that our voices continue to be heard.