The Freedom [sic to the power of 8 billion] Caucus is getting concessions that make already-disgusting legislation considerably worse:
Politico’s Josh Dawsey and Jennifer Haberkorn report that the White House is in negotiations with the House Freedom Caucus about getting the caucus’s hard-line conservative members to support the American Health Care Act, the Obamacare repeal package put forward by House Speaker Paul Ryan and backed by President Trump.
Key to the deal, they report, are changes to the law that would eliminate the Affordable Care Act’s “essential health benefits,” a list of 10 categories of procedure that all insurance plans offered to individuals or small businesses must cover. The 10 are, in the words of Healthcare.gov:
- Outpatient care without a hospital admission, known as ambulatory patient services
- Emergency services
- Pregnancy, maternity, and newborn care
- Mental health and substance use disorder services, including counseling and psychotherapy
- Prescription drugs
- Rehabilitative and habilitative services and devices, which help people with injuries and disabilities to recover
- Laboratory services
- Preventive care, wellness services, and chronic disease management
- Pediatric services, including oral and vision care for children
These provisions set a baseline, mandating that all offered plans meet a certain threshold. They can’t skimp out and not cover big things like emergency room visits or pregnancy or mental health. Particularly for previously undercovered areas like mental health and addiction services, which plans didn’t have to cover before the ACA, this provision was a huge deal.
As to the question of whether this could pass the Senate even thought these regulatory changes would seem to be inconsistent with the Byrd rule, well, a determined Senate majority can essentially do what ever it wants irrespective of internal procedural rules and norms. McConnell’s behavior so far would seem to suggest that said determined majority isn’t there, and it seems unlikely that an even wingnuttier and less popular bill would make things better. But it would be preferable if we didn’t have to find out.