People Hate Trump's Budget Director Maternity Plan

by Jon Hecht
Chip Somodevilla/Getty Images News/Getty Images

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.

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.

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.

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.

Over the course of Friday, numerous Republicans announced they'd vote no on the bill, some citing the removal of essential benefits for patients.

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.