Wednesday, February 22, 2017

Meanwhile, back at Obamacare

Don't get me started....

Promises, promises....

"Many of the questions were without clear answers from Blackburn, who served on Trump's transition team and is carrying key legislation that will be a part of the repeal effort from the GOP-led House. She said the replacement will include provisions allowing people of certain age groups with pre-existing conditions to get insurance.

"She said the replacement plan will be 'more responsive and more affordable' as well, without going into many specifics."
Because it's money that matters in the U.S.A.:

As Republicans look at ways to replace or repair the Affordable Care Act, many suggest that shrinking the list of services that insurers are required to offer in individual and small group plans would reduce costs and increase flexibility.

"Increase flexibility" is weasel-speak for "Not cover so damned much, because people are too damned expensive!"  For example:

That option came to the forefront last week when Seema Verma, who is slated to run the Centers for Medicare & Medicaid Services in the Trump administration, noted at her confirmation hearing that coverage for maternity services should be optional in those health plans.

Pre-natal care?  Maternity care?  Why should we pay for other people's pregnancies?  And then, of course, there are the children.  We love our children; but other people's children?

Pediatric oral and vision care requirements, another essential health benefit that's not particularly common in employer plans, could also be weakened, says Caroline Pearson, a senior vice president at the consulting firm Avalere Health.

If you're noticing a pattern here, it's that government should be run like a business, and business doesn't like to provide greater health insurance coverage than it has to; so a lot of this discussion is turning around what is common in employer health-care plans.  Because that's our consumer society morality:  What Would A Reasonably Pecuniary Board of Directors Do?

Before the health law passed, just 12 percent of health policies available to a 30-year-old woman on the individual market offered maternity benefits, according to research by the National Women's Law Center. Those policies that did offer such benefits often charged extra for the coverage and required a waiting period of a year or more.

The essential health benefits package plugged that hole very cleanly, says Adam Sonfield, a senior policy manager at the Guttmacher Institute, a reproductive health research and advocacy organization.

"Having it in the law makes it more difficult to either exclude it entirely or charge an arm and a leg for it," Sonfield says.

Maternity coverage is often offered as an example of a benefit that should be optional, and that's what Verma has advocated. If you're a man or too old to get pregnant, critics of the requirement say, why should you have to pay for that coverage to be included in your policy?

But that a la carte approach is not the way insurance is designed to work, says Linda Blumberg, a senior fellow at the Health Policy Center at the Urban Institute. Women don't need prostate cancer screening, she points out, but they pay for the coverage anyway.

"We buy insurance for uncertainty and to spread the costs of care across a broad population so that when something comes up, that person has adequate coverage to meet their needs," Blumberg says. 

Viagra is a drug insurance should cover; birth control is not.

It's just good business!

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