How You & Your Kids Are Under Attack by the New Health-Care Bill

mom holding baby's hand
News that the House of Representatives passed a bill to rescind the Affordable Care Act (aka Obamacare) has been rocking social media this week, and it's left moms and dads across the country on tenterhooks, wondering what the Senate will do. If the senators approve the American Health Care Act (AHCA) that curried favor in the House or something like it, what happens to health insurance for our kids? For us? For women and families in general?


A lot, says Caitlin Donovan, director of outreach and public affairs for the National Patient Advocate Foundation.

"Women and children would be disproportionately affected by the cuts in this bill," Donovan tells CafeMom. "For instance, for some reason the cuts to Medicaid received a lot of attention a few weeks ago during the first iteration of the AHCA, but has disappeared a bit from the conversation this time. We should absolutely be talking about those cuts, because women make up the majority of Medicaid recipients, and often their children are covered under the program too. Cutting Medicaid cuts health care for women and children."

What's more, Donovan says the bill will allow states to waive something called the Essential Health Benefits (EHB) package, which required insurers to include maternity coverage -- something she says most pre-ACA plans sold on the individual market did not include -- as well as breastfeeding assistance, free breast pumps, and wellness care for women and kids (aka those well care visits a child generally gets around his or her birthday each year).

And even if you have employer-based insurance and your state doesn't buy into the AHCA waiver of the EHB packages, you could still face a problem because larger employers will be able to choose what state in which to base their insurance. 

"That state's decision, for instance, to waive EHBs would affect employees in all states, not just those who are physically residing in the state," Donovan explains. "For instance, even though I live in New Jersey, my coverage is through a plan based in Virginia. Thus, Virginia's determination would affect me, even though I do not live there."

Darcy Zalewski is one of the hundreds of thousands of parents weighing that concern today. She's on an employer-based plan, albeit one that's based in a different state because her husband works remotely for his employer.

She's afraid to go to the doctor right now, afraid that she'll be diagnosed with something that might be considered a preexisting condition under a new law and preclude her from getting insured down the road. 

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"If the AHCA passes the Senate, I am afraid of what that will do to my family's health insurance coverage," the mom of two from Wisconsin tells CafeMom. "Our health insurance has changed a few times in the past two years due to company acquisitions. What if that happens again and our family is denied coverage?"

Darcy's daughter gets speech therapy classes, which are funded by Medicaid -- a program the AHCA, as it is now, would potentially gut. And both of her kids have benign heart murmurs, which would qualify as preexisting conditions if her husband were to change jobs and the family saw a lapse in coverage.

"It worries me how these changes will make it increasingly difficult to receive affordable quality health care, if any at all. And this is only how my immediate family would be affected," Zalewski says. "These changes will negatively impact extended family members and friends as well."

That's an understatement. 

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Estimates from the Congressional Budget Office, drawn up on an earlier version of the AHCA, indicate some 24 million Americans stand to be living without health insurance by 2026. When you consider the population is about 321 million people, we're talking 7 percent of the population having no health insurance at all. That's 7 out of every 100 people you know. 

And that's not including people who will have insurance but will see their rates skyrocket and face a long list of conditions that will not be covered.

One report from the AARP estimates that insurance for people in "high risk" pools -- including the elderly and younger people with health conditions, like a child with autism or a mom with diabetes -- could be facing yearly premiums of $25,700. That's more than half the average household income -- $53,179 -- in America. And that's just for one person. That's not a family plan. 

And lest you think "Oh, I'm healthy, I'm not high risk," the Kaiser Family Foundation (KFF) has created a list of conditions that were considered preexisting in the individual market before the ACA, and could under this new plan allow insurers, depending on state waivers, to refuse coverage if you change plans or have a lapse in coverage by an employer.

"Before the ACA, even the definition of a 'preexisting condition' would vary from state to state," Donovan says. "For instance, in some states you would have to be medically diagnosed with the condition to have it count. In others, if the condition existed, even if it was asymptomatic and undiagnosed, it would still count. Terrifying, no? Those type of rules allowed insurers to even deny coverage to newborns with congenital conditions." 

And depending upon the state, even those plans provided by an employer could essentially impose lifetime coverage limits, ban caps on annual out-of-pocket costs, and opt out of essential benefit coverage.

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That could create issues for pregnant women; according to figures from the Center for American Progress, a nonpartisan policy institute, women could faces surcharges of as much as $17,060 for pregnancy under the new plan depending on their policy and state in which they live. Meanwhile the Guttmacher Institute estimates cuts to family planning services will result in 128,000 more unintended pregnancies, including 57,000 more unplanned births and some 55,000 more abortions (and, yes, the plan also includes policy to seriously restrict abortion access).

On the flip side, people trying to conceive could face more trouble on the AHCA as the KFF list of medications that could be denied by insurers includes Clomid, a popular fertility drug. Also on the list is genotropin, a growth hormone often used for kids who are having growth difficulties, as well as popular autism and ADHD meds. 

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In a statement shared with CafeMom, nonprofit health-care watchdog group Families USA also warns the ACHA will allow "states to opt out of ACA protections that prohibit insurers from ...  selling low-quality coverage that does not include 'essential health benefits' -- like hospitalization, mental health services, and maternity and newborn care."

For families who depend on Medicaid -- one fifth of all Americans, according to KFF figures -- the future is likewise uncertain. The AHCA proposes an $880 billion cut to the program over the course of 10 years, a figure that's estimated to cost 14 million Americans their insurance. Also nestled into that is a drastic cut to special education -- after all, schools depend on Medicaid reimbursement as part of providing services to kids, to the tune of $4 billion a year.  

All of this begs the question: What can parents do right now? 

The future of the bill now rests in the Senate, which means calling and writing to your senators to let them know what you think of the AHCA. What should stay, what should be cut? Let them know -- here's all of their phone numbers and contact information

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