Friday, February 06, 2015

The Three Wise Men Wishing To Amend ACA To Remove Obligatory Maternity Care From Health Insurance

Three GOP guys who hate (HATEHATEHATE) the ACA (Affordable Care Act) want to eliminate maternity care as one of the things which health insurance must cover.  To give that some background, most individual health insurance policies before the Era of Obamacare (another name for the ACA, for those who live in happier places with national health care or health insurance) did not cover normal pregnancy and delivery.

Tara Culp-Ressler writes about this:

Nonetheless, it’s evident that the GOP lawmakers — Sen. Richard Burr (NC), Sen. Orrin Hatch (UT), and Rep. Fred Upton (MI) — are looking to undo many of the protections that Obamacare put in place for Americans who may struggle to afford insurance.
The Burr-Hatch-Upton plan would eliminate Obamacare’s expansion of Medicaid, which seeks to expand public health insurance to additional low-income people. It would also scale back the tax subsidies to help people purchase private plans. And it seeks to reduce federal regulation of “essential benefits,” dropping the current requirement for insurers to offer coverage for maternity care.
Obamacare mandates maternity coverage in all of the plans sold on its state-level marketplaces, a provision that quickly became a sticking point among opponents to the health law. Critics have latched onto it as an example of why they believe unnecessarily generous benefits will drive up health costs, complaining that having children is a choice and not everyone will need maternity care. During one House hearing, GOP lawmakers sarcastically asked former Health and Human Services Secretary Kathleen Sebelius if she had ever heard of a man getting pregnant. Now, the Burr-Hatch-Upton plan addresses their concerns.

I love this!  I adore this!  It's such a beautiful example of stupidity.  It's certainly true that only some trans men could get pregnant, but it's even more true that Messrs. Burr, Hatch and Upton were themselves once born.

The point I'm desperately trying to make there is that a large chunk of the so-called maternity care is for the benefit of the child who is being born.  To assume that it only benefits women (that alien and deplorable part of humanity only necessary because of, you know, that birth thing) is stupid. 

See how I went around a circle there?  For the Burr-Hatch-Upton view to make sense we must assume that having children is a choice, a bit like choosing to wear high heels, and that upstanding gentlemen have nothing to do with that choice (no sperm involved, no necessity to continue the species, just an unfortunate choice that women should pay for as they pay for their Louboutins). 

But then why are similar conservative gentlemen so firmly opposed to abortion, so eager to regulate the wombs of this country?

Never mind.  Let's assume that insurance policies shouldn't have to cover anything we ourselves are unlikely to get.  So I no longer need to pay for anything that has to do with the diseases of the prostate or other parts of the male reproductive system?  And men don't have to pay for anything which has to do with the uterus, the ovaries, the female breasts and so on?

Let's go even further:  Why should my insurance cover sports injuries if I never engage in those sports myself?

This way of thinking, my friends, is the slippery slope to not having any pools for health insurance, because we can keep on dis-aggregating those classes into finer and finer slivers.

The only argument that deserves a more honest glance is the one about births not satisfying the insurance requirement of the insurable events being outside the person's control and not easily manipulatable (ok, it might not be a word but you know what I mean) by the insured people themselves.  But a huge proportion of all ill health* fails to satisfy those insurance criteria.  Indeed, health care is a very bad fit with the insurance model.  That's one reason why single-payer systems are more rational than traditional insurance.

*Or of health needs in general.  People getting vaccinated are not currently in ill health, annual checkups are carried out on largely healthy individuals and so on.  A normal pregnancy and delivery is not ill health, but if the appropriate care is missing it can quickly turn into just that.