Republicans Now Considering How to Make a Bad Health Care Plan Into a Complete Wreck


Our acronym for the day is EHB, which stands for Essential Health Benefits. These are things which every health care plan is required to cover, and Obamacare spells out ten of them:

  1. Doctor visits
  2. Emergency room visits
  3. Hospital visits
  4. Prescription drugs
  5. Pediatric care
  6. Lab services
  7. Preventive care
  8. Maternity care
  9. Mental health care
  10. Rehabilitation services

The Republican health care bill is still having trouble getting enough votes to pass, so Paul Ryan is thinking about placating conservatives by repealing all of these EHBs. This means that a health insurer could literally sell you a policy that didn’t cover doctor visits, hospital visits, ER visits, your children’s health care, or prescription drugs—and still be perfectly legal. Here’s a rough estimate of how much we spend nationally on each of these categories of EHB:

There are many problems with repealing Obamacare’s minimum required benefits, but I’d like to list just three:

  • Oh come on. This is ridiculous.
     
  • Even if the current version of AHCA doesn’t cause a death spiral, it sure would if EHBs got repealed. Insurers would assume that anyone who asks for a policy that covers one of these (former) EHBs is pretty sure they’re going to need it. Naturally they’d price their policies accordingly: Worthless policies would get really cheap, but comprehensive policies would get astronomically expensive. Virtually no one would be able to afford them.
     
  • There’s a good chance that repealing the EHBs would not only produce crappier insurance policies, but would also cost the government more money. Think about it. Every year AHCA provides you a tax credit for health insurance. You might as well use it, right? So insurers would all compete to offer policies that cover almost nothing but cost exactly $2,000 or $3,000 or $4,000. Everybody would sign up for one, because it’s free so they might as well. So instead of, say, 10 million people using the tax credits, 30 million would. These policies wouldn’t do squat, but Uncle Sam has to pay for them anyway—and now he’s got to pay for three times as many of them.

This is all pretty straightforward stuff, and it’s hard to believe that Ryan would go down this catastrophic road. Enough’s enough. If I had to guess—and we might well know the answer before I wake up on Thursday—I’d say that Ryan tries to buy off the conservatives by taking maternity benefits off the EHB list and leaving everything else alone. After all, it’s maternity care that really seems to be a burr in the ass of the Freedom Caucus folks.

Why? Because they’re knuckle-draggers. It’s hard to put it any other way. They figure that being pregnant is solely a woman’s responsibility and there’s no reason men should have to help pay for it. Really. I’m not joking. What can you even say to people so terminally dimwitted?