GOP’s Last Minute Plan: Make Insurance Completely Worthless

JM Ashby
Written by JM Ashby

When I said insurance wouldn't be required to cover anything under Trumpcare, I may have said so for effect at the time, but I wasn't necessarily exaggerating.

According to various reports, House Republican leadership has amended their bill in a last-minute attempt to persuade some members of the Freedom Caucus to support it.

This is a list of what insurance would no longer be required to cover under the new version of their bill:

• Outpatient care without a hospital admission, known as ambulatory patient services

• Emergency services

• Hospitalization

• 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

NBC News has a more detailed breakdown of what plans would no longer be required to cover.

Outpatient care — This covers most scheduled doctor visits, such as to check a rash, or a non-emergency stomach ache. Insurance companies negotiate deals for these and often designate "networks" of doctors and clinics with approved charges. Individuals who walk in without coverage pay much, much more.

Emergency room trips — Insurance policies cover both the ER visit and ambulance trips. Otherwise people can get socked with bills totaling tens of thousands of dollars, perhaps incurred while they were unconscious.

In-hospital care — All care people get as hospital patients, such as surgery. Some conservatives argue that people should be able to choose to opt out of this type of coverage and pay lower premiums. Most health policy experts say this is a gamble. "One answer is because someday you may be sick and that's the way that insurance works," says David Cutler, a Harvard University economics professor who helped design the Affordable Care Act.

Pregnancy, maternity and newborn care — This one's controversial to some, who ask why men should pay for a service they'll never use. Pre-Obamacare, many insurance policies specifically excluded maternity care. "It is true that women get pregnant but men kind of help them get pregnant," Cutler said.
Mental health and substance abuse disorder services — This particular benefit has gotten some attention with the ongoing opioid epidemic.

Prescription drugs — Insurance companies usually negotiate discounts. Out of pocket costs for many drugs can be much higher than what an insurer pays for them.

Rehabilitative services and habilitative services — These include help recovering from an injury or illness, but also treatment for kids with autism or cerebral palsy.

Lab tests

Preventive services — This includes vaccines, cancer screenings such as mammograms and colonoscopies and, controversially, coverage of birth control.

Pediatric services — Including dental and vision care for children.

So, in other words, insurance would be required to cover almost literally nothing. Insurance would be a worthless piece of paper.

This is what would have been included in follow-up legislation, or what Paul Ryan has referred to as a "three-pronged approach." It's not clear if adding these regulatory changes to the bill can be passed through reconciliation but, even in that case, it would take only 2 Republican senators to kill the bill and at least a dozen are leaning against it. And that was before House Republicans made the above changes.

Republican Senators Lisa Murkowski and Susan Collins would not support the bill as it was written, and they certainly won't if the above changes are included. Just those two would be enough to stop it.

Needless to say, medical bankruptcies will make a big comeback if this ever becomes law.

  • Draxiar

    Replace it with something terrific….uh huh…

    “This here is a great car, the best car…you’ll never find a car that’s better…it’s far better than that thing you drove onto our lot with. What you don’t get with this car is tires, seats, lights, windshield, doors, windows, gas tank, trunk, hood, engine belts, battery, and spark plugs. Bear in mind this is a terrific car…you’ll never find a better car, believe me.”

    • ninjaf

      But you get the freedom to access any car your heart desires. Not our problem if you can’t afford it.

  • swift_4

    Do not count on Murkowski and Collins to do the right thing. They only vote against their party when it doesn’t actually mean anything.

    • ninjaf

      As we saw during the deal making to get the ACA passed. They moved it right in a bid to try to get some moderate Republicans to sign on. And while Collins voted to get it out of committee, she denied them the yes vote on the floor.

  • Christopher Foxx

    Outpatient care — …

    Emergency room trips — …

    In-hospital care — …

    Prescription drugs — …

    So it’s only failing to cover medical care if it’s provided outside a hospital or inside a hospital. What’s the big deal? You’re fine as long as you’re not in those particular two places.

  • ninjaf

    I’m to the point of saying “Screw it. Let ’em have what they voted for.” I’m tired of them voting for people who promise to do them harm and then getting all surprised when it happens. I know of multiple people who voted for Trump because Obamacare premiums were too high. But their complaint was actually that the subsidies actually didn’t go far enough to include them. They were basically saying that they want single payer health insurance. But instead, they vote for the people who promise to dismantle the whole thing. They vote to cut off their nose to spite their face. Well, let them take a look in the mirror at the gaping maw that used to be their nose that is this healthcare bill.

    (In my more rational moments, I really hope this fails because it will be so horrible for so many.)

    • Tony Lavely

      I’m not sure I’ve reached “my more rational moments” yet. Hopefully, soon.

  • Georgie
  • gescove

    With that list of items not covered, what exactly would be the point of paying for insurance? Aren’t insurance companies even a little bent at the prospect of losing millions of customers?

    • muselet

      It’s my understanding the health insurance industry as a whole is … erm … less than enthusiastic about RepubliCare.


  • Username1016

    They should flat-out list what IS covered. First of all, it would be a much shorter document. And second, I think the effect of these cuts would be way clearer. (Yep, an aspirin. Maybe.)

  • Badgerite

    Dear God. If I were Paul Ryan’s parish I would block the doors when I saw him coming. What exactly would you get for purchasing this ‘insurance’. An asprin?

    • Apparently viagra.

    • Tony Lavely

      Only generic aspirin. Not Bayer or Aleve or a named product.

  • muselet

    Watch, the House Flying Monkey Caucus will vote against the bill because it’s still “too generous.”

    These are terrible people.