Senate’s version of newer legislation intended to repeal and replace ACA – affordable care act termed as Better Care Reconciliation Act of 2017, brings but only a few changes.
Concern over its impact on low-income Americans, people with pre-existing conditions and women is growing. Surprisingly, according to Dr. Haywood Brown, president of the American Congress of Obstetricians and Gynecologists (ACOG) it will undo most of the landmark women’s health gains of affordable care act by limiting access to affordable care. Top health groups bemoan the fact their inputs were spurned. The legislators have rejected women’s health expertise but instead created the bill within closed doors. Haywood’s plea to the Senate is to scrap this bill and begin from scratch.
The bill as of now can affect women and families in four ways:
1. Many women could lose basic benefits
Affordable Care Act mandated plans on individual market place cover all essential health benefits without charging patients. This meant women benefitted from services of maternity coverage, contraception, mammograms, cervical cancer screenings, well-woman visits, breast pumps and domestic violence screening and counseling. Even though this was not compulsory for larger employer plans, these services were given without annual or lifetime limits.
New House bill is preferring to leave these options to individual states. The Senate bill seems to have the same loophole as pointed out by Leighton Ku, professor of health policy and management at George Washington University’s Milken Institute School of Public Health. Accordingly, it’s possible that health insurance will be sold without maternity coverage or prescription drug coverage limitations. Both employer-sponsored plans as well as private insurers would leave these benefits out of their plans. It’s still not clear what government will allow.
2. Medicaid would suffer deep cuts
Cuts in federal funding to Medicaid expansion intended to reduce uninsured residents would suffer. Caps on funding amount to states will make Medicaid programs severely underfunded. Since Medicaid funding is on enrollment numbers and health-care costs, more women and births in United States will be affected.
Dr. Michelle Moniz, assistant professor of obstetrics and gynecology at the University of Michigan says, “Funding cuts mean coverage for fewer people or fewer services and if those essential health benefits like maternity care and contraception aren’t protected, women and children could be in real danger of losing care.”
A requirement of person to be working to receive Medicaid may affect a young mother. “Medicaid not covering costs of her child-care needs could create a serious problem.”
3. Preventive care could be curtailed
Effects of curtailed Medicaid reimbursement to Planned Parenthood would prevent women using services for well-woman visits, cervical cancer screenings and access to low-cost contraception and testing for sexually transmitted infections. More and more Planned Parenthood locations may close down totally.
Boosting community health centers with money as an alternative will not work due to absence of professionals. Who will provide long-acting contraceptives and ongoing health-care services for women? Asks Dr. Hal Lawrence, executive vice president of ACOG. “They’re not equipped to fill that gap.”
4. Fewer women may have insurance
Most importantly, the Senate bill eliminates individual mandate required individuals to have health insurance or pay a tax. Similarly, requirement for companies with 50 or more employees to provide health coverage for their workers could be done away with. Moniz says, “This will give rise to more uninsured people no longer having access to affordable health insurance.” Women will be affected more than men will.
Women do face unique circumstances, especially around childbirth, making medical insurance extremely important. It will make the problem of United States having highest maternal mortality rate in developed world worse than before. Fitting care during labor and delivery is necessary to save women, children lives and improve their health. Women must have access to doctor before and during pregnancy—screening for complications like hypertension and diabetes.
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