Being a father isn’t what it used to be, in a good way. I can participate in my son’s life as much as I wish, unbound by societal expectations, rigid class rules and gender roles that constrained generations before. My wife and I can be equal partners in parenting, regardless of who works outside the home, makes more money or is better at making Play Doh castles (that’s me, by the way).
But as much as things change, some things remain constant. I feel, as my father did, a resounding duty to protect my family from as many dangers as I can. And as I reflect on my role as a father this Father’s Day, I also reflect on how much parents in North Carolina rely on the protections of the Affordable Care Act to keep our families healthy, and the threat those protections now face.
The House of Representatives’ vote to repeal the ACA and radically restructure Medicaid offers families no cause for celebration. Their American Health Care Act takes health care away from 24 million Americans, raises premiums by 20 percent and unravels critical consumer protections, putting mothers of all ages – and their families – at risk.
The Affordable Care Act ended a broad range of discrimination in the insurance market for women, much of it based on the potential for women to become mothers. It created new rules that barred insurers from charging women more than men for the same policy; from selling women policies that didn’t even include prenatal, maternal and preventive care, like contraception; and from treating pregnancy, C-sections and postpartum depression as pre-existing conditions.
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The Essential Health Benefits provision of the ACA requires insurers to provide coverage for prenatal, maternity and newborn care, as well as nine other categories of basic services, including no-cost preventive care that helps women plan for children, ensures healthy pregnancy and delivery, and provides hospitalization – which most pregnant women require at some point – as well as lab and pediatric services needed to care for their children.
The Republican bill allows insurers to opt out of these requirements so they can go back to charging more for pre-existing conditions. That means they can resume charging the 4 million women a year who become pregnant more for their coverage and treating C-sections, mental illness, domestic abuse or even rape as pre-existing conditions.
The Republican bill also puts health care in jeopardy for many millions more by ending traditional Medicaid as we know it. This restructuring would make permanent cuts to health care services for seniors, people with disabilities and mothers and children, and would turn back the clock not just on the ACA, but also on the Medicaid program that has served families well for over 50 years.
More than 2 million people get health care through Medicaid in North Carolina, including 21 percent of our state’s seniors, and 42 percent of children. Medicaid is particularly important for mothers and families. It is not only the nation’s largest payer of family planning services, but it also pays for nearly half of the births in the country. Medicaid financed more than half of North Carolina births in 2015.
Permanent cuts to Medicaid in the Republican bill through arbitrary payment caps mean greater struggles for mothers in caring for their children, and more challenges for all of us who care for aging parents, especially elderly women. Women are more likely to be poor, to develop a disability as they age and to live longer than men. Medicaid will become even more critically important for aging women as seniors become a larger proportion of the overall population. Over the next three decades, the number of people over 65 will almost double, and more than two-thirds of seniors who receive Medicaid are women. Many depend on it for long-term care in nursing homes and through in-home care services; 3 out of 4 nursing home residents and 2 out of 3 home health care recipients are women.
Medicaid is indispensable for women at all ages, and for mothers in all stages of motherhood. The Republican bill cuts over $800 billion out of Medicaid while at the same time providing about $600 billion in tax breaks to the rich, insurance and pharmaceutical companies. Meanwhile, struggling moms would pay more out-of-pocket for health care or lose coverage under the GOP plan, and their aging mothers and their children would face potential loss of services. That’s why the American Academy of Pediatricians, Planned Parenthood Federation of America, the AARP, the March of Dimes, the American Medical Association and dozens of other patient and health care advocacy organizations oppose the Republican bill.
The best Father’s Day gift that I and other North Carolina dads could receive is a commitment from Sens. Thom Tillis and Richard Burr to join in opposition to this unjust House bill. We should be building on the success of existing programs to improve health care for mothers and families, not scrapping the current system and starting from scratch.
Kevin J. Rogers is the policy director for Action NC and teaches political science at William Peace University.