Despite promises to repeal Obamacare, the American Health Care Act is massively unpopular, which is part of why President Trump's bill to replace the Affordable Care Act is likely going down in Congress. The bill faced opposition from many sides, including from constituents and medical advocacy groups, conservative think tanks and members of Congress, and of course, Democrats. Speaking to CBS Friday morning, White House budget director Mick Mulvaney defended moving rules about covering maternity care to state control: When asked what that means for mothers who live in a state that chooses not to require maternity coverage, Mulvaney said: "Then you figure out a way to change the state that you live in."
He added that that didn't necessarily mean people should move, but rather that they could "look to try to change their state legislatures and their state laws."
As a last-chance attempt at placating some of those conservatives, the bill was amended to remove the "essential health benefits" provision of Obamacare, which required insurance plans to cover some minimum benefits to count. Some of these are pretty no-brainer for what you'd think of as a health insurance plan — hospital visits, outpatient doctor care, prescription drugs. But one of them, which was especially targeted by conservatives, has taken up a special spot of controversy.
"You can figure out a way to change the state you live in." —Mulvaney on cutting federal mandates for essential health benefits pic.twitter.com/oNv8dxchcH— Kyle Griffin (@kylegriffin1) March 24, 2017
Imagining a scenario where pregnant mothers try to lobby their state governments in the ninth months before they have a baby seems pretty onerous. It's especially worrying coming at the same time as a Texas bill (one of those state governments Mulvaney thinks should be writing the rules on maternity coverage) that allows doctors to lie to their pregnant patients about problems with a fetus.
Many people were unhappy.
Mulvaney is 1 of these sanctity of life people where a fetus must be protected at all costs &after it's born it can starve& have no med care https://t.co/pFaqowg5pW— ZanSmith (@Zanlaughsatyou) March 24, 2017
Nah, I think we'll change Budget Directors instead. Enjoy that spot while it lasts trumpkin Mulvaney.https://t.co/RcDHYb5K3G— Steph (@NOLADuchess) March 24, 2017
So, Melania and the kid stay in NYC to not disrupt his school year; but, WE HAVE TO MOVE for basic survival? Screw you, Mulvaney. https://t.co/zZo16VA6ci— Analogbear (@Analogbear) March 24, 2017
Ending essential health benefits was a difficult idea already. Some health experts believe that scrapping the minimums would allow insurers to create junk plans that don't provide anything useful but can get government subsidies anyway, and that the idea will likely lead to much higher costs for those that have more expensive health needs.
To the question of why stripping essential benefits are bad, testimony I sent to MN House when they considered doing it. pic.twitter.com/ceI2v7YO4v— Andy Slavitt (@ASlavitt) March 23, 2017
And it certainly didn't help that the photo put out by the White House accompanying the meeting on cutting maternity care requirements was a room full of old white men.
The group proposing to cut breast cancer screening, maternity care, and contraceptive coverage. pic.twitter.com/CxsrxZmcqz— Matthew Yglesias (@mattyglesias) March 23, 2017
Over the course of Friday, numerous Republicans announced they'd vote no on the bill, some citing the removal of essential benefits for patients.
Deeply revealing. These insurance mandates are the foundation of Obamacare. It suggests many Republicans secretly never wanted full repeal. pic.twitter.com/AIS6XXvBHa— Sahil Kapur (@sahilkapur) March 24, 2017
Passing a bill with so much impact would have been hard no matter what. But when Mick Mulvaney went on television and phrased removing guaranteed maternity care in such an uncaring way, it certainly made it difficult for Republicans to defend their already unpopular bill.