Editorials

The Republican Mother’s Day gift? Higher bills, sicker kids and no choice

Health reforms being pushed by President Donald Trump, shown here during the campaign, and Republicans in Congress would take an especially harsh toll on women.
Health reforms being pushed by President Donald Trump, shown here during the campaign, and Republicans in Congress would take an especially harsh toll on women. New York Times file

Some 4 million babies were born last year in this country. Next year’s babies may envy them.

Thanks to the Affordable Care Act, their parents’ insurance had to cover their prenatal care and delivery. Health plans couldn’t treat them – as in the past – as little “pre-existing conditions.”

Their moms didn’t have to worry about their premiums rising just because they had had children, or just because mothers, actuarially speaking, happen to be female.

Nor did they have to fear other pre-Obamacare throwbacks: If they were born with a chronic medical condition, for instance, insurers couldn’t impose the sort of lifetime caps on coverage that, in the past, often ran out with the first hospital visit.

Of course, too few babies got the bonding time critical to developing children; though most U.S. women are in the workforce, no industrialized nation on Earth offers less maternity leave than this one.

Even in California, where lucky Silicon Valley employees get some of the most generous family leave benefits in the nation, the state’s paid family leave law lacks job guarantees for nearly half of the rest of the workers.

The version of the American Health Care Act passed by the House would punish mothers from every possible angle.

It’s a problem: 1 baby in 8 is born in California, and every private sector worker kicks into the paid family leave kitty, yet small-business employees can be fired if they take time off to bond with their newborns.

Still, thanks to Obamacare, at least children born to working moms last year didn’t have to worry about nursing. The law requires that insurance cover breast-feeding support and equipment, including breast pumps, without a co-payment. And workplaces must offer pumping breaks for up to a year and someplace other than a restroom to pump in private.

And the babies of 2016 could, in historic numbers, rest assured that they were wanted. Thanks to mandated coverage for contraception and subsidized birth control from Planned Parenthood and others, more U.S. women than ever were able to choose when and whether to have children.

Also, thanks to evidence-based teen pregnancy prevention, fewer babies than ever were born to teen girls.

Unfortunately, most of that is now back on the table. The Republican health reform worming its way through Congress is among the most anti-woman, and thus anti-child, pieces of legislation to come out of Washington in a very long time.

The version of the American Health Care Act passed by the House would punish mothers from every possible angle:

▪ It would radically shrink Medicaid, which pays for about half of all births in California and the country. One American woman in five is on Medicaid now; it is the leading source of coverage for low-income women and supplements coverage for nearly a fifth of all senior women.

▪ It would dramatically curtail birth control. Medicaid pays for three-quarters of all family planning. Cuts would affect that, and other language would bar reimbursement for Planned Parenthood, which subsidizes contraception for millions annually, including more than 600,000 Californians.

Obamacare also required private plans to fully cover contraception. That’s being rolled back for employers with religious objections, thanks to an executive order by President Donald Trump.

▪ It would end the Obamacare requirement that health plans cover “essential benefits” such as maternity care. Those essentials also include most of the services parents think of when they buy insurance: vaccinations, emergency care, lab tests, newborn care, pediatric vision and dental care, nursing equipment and contraception. Letting states opt out of those mandates would open the door to low-quality, fly-by-night health plans and would end other critical safeguards.

▪ It would reopen the door to penalizing women for pregnancy and other “pre-existing conditions.” Before Obamacare, health plans could deny coverage to women who had been treated for breast cancer, pregnancy, cesarean sections and postpartum depression. The GOP plan maintains that ban. But it then lets states open a back door through which insurers could spike premiums for individual policyholders with prior health issues if their coverage lapses.

Thus, women soon could have less access to birth control; massive costs when they inevitably get pregnant; no guarantee that their maternity care will be covered by their insurance; and no maternity leave unless they live in a state like California, where even the best paid family leave laws are limited.

Half of the population shouldn’t be limited to less than quarter of state legislators and less than a fifth of Congress.

Happy Mother’s Day, America.

This can be fought, but it will take labor. The American Health Care Act, passed by a 91 percent male House Republican Caucus, is now in the Senate, where a 100 percent Republican male panel is amending it.

Calls to Congress still matter. And state lawmakers can mitigate some incoming damage. Tobacco tax money, for example, could be set aside to keep Planned Parenthood and other family planning clinics in business in California. State rainy-day funds could triage some Medicaid cutbacks.

A state bill, Senate Bill 63, would extend job protections to workers who take parental leave from businesses with 20 or more employees. The threshold for subsidized child care can be tweaked so low-income women won’t be bumped off the rolls by the minimum wage increase the state passed last year.

Longer term, though, the best cure for institutional misogyny is more women in office. Half the population shouldn’t be limited to less than a quarter of state legislative seats and less than a fifth of Congress. As the saying goes, if you aren’t at the table, you’re on the menu. So in 2018, ask who wins when mothers lose, and vote accordingly. Do it for the babies. Do it for Mom.

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