During a March 9 debate in the House Energy and Commerce Committee on the GOP’s plans to revise the Affordable Care Act, Democratic Rep. Mike Doyle (Pa.) began questioning the GOP’s issues with Obamacare’s health-insurance plan requirements. Since being signed into law by Obama in 2010, the ACA stipulates that all health plans cover essential benefits, including prescription drugs and hospital and doctor visits. Additionally, Obamacare requires that health plans cover pregnancy and child birth.
Although the debate lasted 27 hours, its most contentious moment occured — arguably — as soon as Doyle questioned Rep. John Shimkus’ (R-Ill.) objections to the law’s coverage of prenatal care. Shimkus asked, “What about men having to purchase prenatal care?” He continued, “I’m just… is that not correct? And should they?”
Well, Shimkus, you are indeed correct.
In a column written for Consumer Reports in 2013, insurance expert Nancy Metcalf explains, “Health insurance, like all insurance, works by pooling risks.” A risk pool creates an umbrella over various types of health care one might need from birth to death. Although certain individuals may never need the coverage their health plans provide for certain issues, “if you slice and dice risks, eventually you don’t have a risk pool at all, and the whole idea of insurance falls apart…”
This is why, like men’s health insurance incorporates charges for the potential need for prenatal care, women’s health insurance incorporates charges for Viagra, prostate cancer screenings, heart attacks and high blood pressure, though — if I’m correct — by virtue of their femaleness, it is highly unlikely that they will need this health care.
As noted by the Washington Post, the Doyle-Shimkus exchange recalls a similar conflict in the Energy and Commerce Committee from 2013, when Rep. Renee L. Ellmers (R-N.C.) asked health and human services secretary Kathleen Sebelius, “Do men not have to buy maternity coverage? To the best of your knowledge, has a man ever delivered a baby?”
I want to ask, to the best of your knowledge, has a woman ever needed a prostate cancer screening? Taken Viagra? Should she pay for potential heart attack and high blood pressure risks when she is statistically less likely to develop those issues? But of course “[slicing and dicing] risks” ignores more complex issues with gendering healthcare: what about trans men, trans women, and nonbinary individuals whose healthcare needs aren’t adherent to binary norms? What about other individuals whose bodies differ from what insurers expect of them? What about the huge percentage of women over 65 who do suffer from cardiovascular disease? What about women who can’t afford prenatal care without ACA coverage? Prior to Obamacare, when insurers could exclude maternity coverage from individual plans, maternity riders often cost more than entire policies themselves and carried a 5,000 deductible. In those cases, only the most planned and privileged pregnancies were eligble for coverage.
If Republican lawmakers can’t understand that diverse healthcare and socioeconomic needs in the U.S. require a diversified risk pool, and that healthy-but-insured women and men both subsidize this risk pool equally, doesn’t the GOP have better questions to ask than whether men can get pregnant? Is that not correct?
Top photo: Wikipedia Commons
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