Illinois rep asks why men should have to pay for prenatal coverage
In the 27 hours the House Energy and Commerce Committee spent debating Republicans’ Affordable Care Act revision plan, a handful of moments stand out.
This is one of them.
At the start, Democratic Rep. Mike Doyle (Pa.) was talking with Republican Rep. John Shimkus (Ill.) about his objections to the Affordable Care Act’s requirements for health-insurance plans.
As a reminder, former president Barack Obama’s signature 2010 health-care law ordered that all health plans cover certain essential health benefits, such as doctor visits, hospital care and prescription drugs.
The law also required plans to cover pregnancy and childbirth. That’s where the fireworks started in the Energy and Commerce Committee.
“What mandate in the Obamacare bill does he take issue with?” Doyle asked Shimkus, using the formal parlance of congressional committees.
“What about men having to purchase prenatal care?” Shimkus said.
At that point, one could hear the room start to stir.
“I’m just . . . is that not correct?” Shimkus said. “And should they?”
The moment is starting to circulate on social media, along with criticism of Shimkus.
NARAL Pro-Choice America, a group that advocates for abortion rights, called attention to it on Twitter and included the video:
Shimkus was raising a question common among opponents of the ACA.
In 2013, during another famous exchange in the Energy and Commerce Committee, former Rep. Renee Ellmers, R-N.C., brought up the same thing with former health and human services secretary Kathleen Sebelius.
“Do men not have to buy maternity coverage?” Ellmers said, referring to the health-care law’s essential health benefits. “To the best of your knowledge, has a man ever delivered a baby?”
Here’s how insurance expert and columnist Nancy Metcalf answered a similar question from a Consumer Reports reader that year:
Health insurance, like all insurance, works by pooling risks. The healthy subsidize the sick, who could be somebody else this year and you next year. Those risks include any kind of health care a person might need from birth to death-prenatal care through hospice. No individual is likely to need all of it, but we will all need some of it eventually.
So, as a middle-aged childless man you resent having to pay for maternity care or kids’ dental care. Shouldn’t turnabout be fair play? Shouldn’t pregnant women and kids be able to say, “Fine, but in that case why should we have to pay for your Viagra, or prostate cancer tests, or the heart attack and high blood pressure you are many times more likely to suffer from than we are?” Once you start down that road, it’s hard to know where to stop. If you slice and dice risks, eventually you don’t have a risk pool at all, and the whole idea of insurance falls apart.
Before the new health law took effect, insurers can and did exclude maternity coverage from individual plans. In fact, in half of states you can’t purchase maternity coverage on the individual market for any price. In most of the rest, you can buy a maternity rider on your policy. In many cases it costs more than the main policy itself, and you can’t use it for at least a year after you buy it, and it often has a separate deductible of up to $5,000.
Why so expensive? Because the only people who buy it are, naturally, people planning to have a baby. Insurers know this and price accordingly.
Requests for additional comment from Shimkus and Doyle were not returned.
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