One of my favorite moments of the legislative debate on the Affordable Care Act came in September 2009, during an otherwise unremarkable committee hearing. Sen. Jon Kyl (R-Ariz.), at the time the Senate Minority Whip, was complaining bitterly about proposed benefits to be included in a standard benefit package.To drive home his point, the Arizona Republican said, "I don't need maternity care.""I think your mom probably did
," Sen. Debbie Stabenow (D-Mich.) replied.While that should've effectively ended the argument forever, four years later, this came up again during a House hearing, when Rep. Renee Ellmers (R-N.C.) also complained
about standard benefits covering maternity care. "To the best of your knowledge has a man ever delivered a baby?" the Republican congresswoman asked Health and Human Services Secretary Kathleen Sebelius.This week, as the Washington Post reported
, it happened once more, as yet another GOP lawmaker took aim the "Obamacare" provision that requires health plans to cover pregnancy and childbirth.
At the start, Democratic Rep. Mike Doyle (Pa.) was talking with Republican Rep. John Shimkus (Ill.) about Shimkus's objections to the Affordable Care Act's requirements for health-insurance plans.... "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?"
Apparently, the point of this preoccupation with the issue is the Republican belief that the ACA isn't fair to men because it forces them to pay for a benefit they'll never, physiologically, be able to use. Scrapping the guarantee, the argument goes, will make coverage cheaper.As we discussed
the last time this came up, it’s worth appreciating the fact that the Affordable Care Act’s architects set up the system deliberately so that women wouldn’t be penalized for being women, and they wouldn’t be forced to pay more for the coverage as men. This is a feature not a bug.
The New Republic
's Brian Beutler had a good piece
on this a few years ago.
The Affordable Care Act’s requirement that insurers cover maternity care is a major manifestation of its broader prohibition against gender rating. Before Obamacare, it made sense actuarially for insurers to charge women more than men for coverage on the individual market. The fact that women, rather than men, incur maternity costs was a big part of their justification, though women were also generally charged more for equivalent coverage. By prohibiting the practice, Obamacare doesn’t just strike a blow for moral reasoning. It effectuates a billion-dollar transfer of wealth from men to women.
By undertaking to foist the costs of maternity care back onto women alone, Ellmers was proposing, perhaps unwittingly, to transfer all of that wealth from women back to men.
The fact that GOP lawmakers are still hung up on this, despite the implications of turning back the clock, continues to amaze me.