Deep Concern for the Welfare of Childbearing People
With the Senate’s release on June 22 of the Better Health Reconciliation Act of 2017, NACPM is deeply concerned for the health and well-being of childbearing people, babies and families in the United States. We urge you to acquaint yourself with this bill and call your Senators today to ask them stop this repeal of the Affordable Care Act (ACA).
This legislation, drafted behind closed doors by 13 Republican Senators over the past several weeks, is the Senate’s version of Congress’ effort to repeal the Affordable Care Act. It retains the basic structure of the American Health Care Act (AHCA) passed by the House of Representatives on May 4 of this year, which the Congressional Budget Office projected would cause over 23 million people to lose health care coverage over 10 years.
In March of this year, NACPM released a statement describing the gains for women as a result of the ACA, and the consequences for childbearing people with a repeal of the ACA. Now with the release of the Senate’s bill, this population is more at risk than ever.
Maternity Care Once Again not an Essential Health Benefit
The ACA requires all health plans, with a few exceptions, to cover a set of Essential Health Benefits (EHBs), including maternity care. Just 7 years ago, prior to the ACA, pregnant people frequently could not obtain insurance, maternity and newborn care were not considered essential health benefits and there were multiple barriers to health insurance coverage. The Senate bill would allow states to opt out of covering the Essential Health Benefits, once again leaving pregnant people without access to coverage. Birth impacts everyone at the beginning of life, and 85% of women become pregnant at least once during their lifetimes. The cost of having a baby averages $18,329 and $27,866 for a cesarean section. Almost 1 in 3 births is a cesarean section. Shifting these costs once again back to people having babies, including the poor and most vulnerable, is not sustainable or conscionable.
Drastic Cuts to Medicaid
While the Senate bill contains funds to stabilize the insurance markets and softens some of the provisions in the AHCA, these seeming improvements mask drastic changes to our health care system and deep cuts to Medicaid. Under the provisions of the ACA, 31 states and the District of Columbia took advantage of new federal funding to expand their Medicaid programs, providing new coverage to millions of Americans who had previously not had access to coverage. The Senate bill would phase out this expansion of Medicaid completely by 2024, affecting health care coverage for these millions of people, albeit more slowly than the AHCA, which calls for a phase out by 2020. By changing the mechanisms for determining the federal share of Medicaid spending, it also would impose deep cuts to the Medicaid program in future years, significantly rolling back the federal commitment to Medicaid. States would be left with stark options for reducing services or eliminating many of those newly eligible for coverage, effectively ending Medicaid as we know it now. Currently, Medicaid pays for the health care for 1 in 5 Americans and approximately half of all births in the U.S.
Tax Cuts for the Wealthy Paid for by the Poor
This legislation would reduce the subsidies provided in the ACA that make insurance affordable to people of low and moderate income, and would limit access to coverage for many now eligible by lowering income eligibility levels. It would repeal the taxes put in place by the ACA to pay for expanded coverage for low and moderate-income people, including a payroll tax and a surtax on net investment income. In effect, large tax breaks for the wealthiest Americans – those least in need – will be paid for by taking insurance coverage away from poorer people who are most in need.
A Call to Action
This bill is expected to come to the floor of the Senate this week. Only 20 hours will be allowed for debate. The defection of only 2 Republicans would spell its defeat. NACPM is reaching out to Senators about our deep concerns for the welfare of our citizens. We urge you to call your Senators today!
How to Call Your Senators
- Call the Congressional switchboard at 202-224-3121 and ask to be connected to one of your Senators.
- Once you are connected, say:
“As your constituent, I urge you to reject the Better Health Reconciliation Act and the repeal of the Affordable Care Act with its critical protections for childbearing people and their babies. I am a midwife (or consumer of maternity care, etc.) and am deeply concerned that maternity care would no longer be required to be covered by insurance. Medicaid pays for ½ of the births in our country and this bill will severely undercut coverage of these services. (Tell a short personal story of why you oppose the Senate bill – this adds much power to your message.)
- After you call one of your Senators, call the switchboard again to call your other Senator.
- Share any comments or feedback you receive with us by writing to firstname.lastname@example.org.