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The latest version of Trumpcare makes covering pregnancy, hospitalization, and drugs optional

Reuters/Mansi Thapliyal
Time to start lobbying your state government.
By Heather Timmons
Published Last updated This article is more than 2 years old.

A last-minute tweak to the American Health Care Act, the bill that would repeal Obamacare, will leave it up to state governments to decide whether they want to require “essential health benefits”—a list of bedrock services like prescription drugs and hospitalization insurers must now provide.

An amendment introduced late on March 23 “requires states to determine essential health benefits, beginning in 2018,” meaning that they can choose not to cover things such as:

  • Ambulatory patient services (outpatient care you get without being admitted to a hospital)
  • Emergency services
  • Hospitalization (like surgery and overnight stays)
  • Pregnancy, maternity, and newborn care (both before and after birth)
  • Mental health and substance-abuse disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
  • Prescription drugs
  • Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
  • Laboratory services
  • Preventive and wellness services and chronic-disease management
  • Pediatric services, including oral and vision care (adult dental and vision coverage aren’t considered essential health benefits)

Mick Mulvaney, director of the White House’s Office of Management and Budget, told CBS News, “What we’re doing is taking away the federal control of these systems.” The move was designed to appeal to the “Freedom Caucus,” a group of about 30 Republicans opposed to the original proposal backed by president Donald Trump. They want lower taxes and fewer government directives.

When asked what a pregnant woman whose state didn’t cover maternity care should do, Mulvaney said: “You can figure out a way to change the state you live in.” He added that pregnant women could “try to change their own state legislatures and their state laws.”

“Why do we look to the federal government to try to fix our local problems?” he added. “That’s one of the big problems of Obamacare.”

Before the Affordable Care Act, as Obamacare is formally known, maternity care was rarely available at all outside of employer-associated group plans, as the Atlantic explains, and “prohibitively expensive when it was, because insurers expected that anyone who purchased it was intending to have a child and thus planned to access the benefits.”

Planned Parenthood calls the AHCA the worst women’s health legislation in a generation. “Simply put, this bill makes it harder for women to prevent unintended pregnancy, harder to have a healthy pregnancy, and harder to raise a healthy child,” the organization said on Friday.

Voting is scheduled to start at 4:30pm today (March 24), and at this point the bill is widely expected to fail, in part because gutting essential health benefits has upset more moderate Republicans.

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