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GOP Lawmaker's Amendment to AHCA Would Reinstate Essential Health Benefits

Rep. Tom MacArthur

House Rep. Tom MacArthur (R., N.J.), co-chair of the Tuesday Group, has introduced an amendment to the American Health Care Act which would reinstate essential health benefits as a federal standard.

Introduced on March 6, 2017, the American Health Care Act was pulled for a vote on March 24, after it was clear the legislation would not receive enough support to pass. The House Freedom Caucus, which has more than 30 members, opposed the bill, with members saying the replacement does little to deliver on the Republican promise to fully repeal Obamacare.

Members of the more moderate House Tuesday Group said the bill didn't go far enough to cover individuals and provide premium subsidies.

"When the American Health Care Act was first introduced, I grappled with whether I would support it," said Rep. MacArthur. "Over the past weeks, I worked with President Trump, Vice President Pence, Speaker Ryan, HHS Secretary Tom Price, and Members of Congress with different views, about my concerns."

"I offered and fought for specific improvements that needed to be included in the legislation in order for me to support it," he said.

Now MacArthur has introduced an amendment to the legislation that would keep some provisions of the Affordable Care Act.

Under Obamacare, health care plans were required to include essential health benefits, or 10 categories of services such as pregnancy care, mental health services and child care. While the American Health Care Act required that states define the essential health benefits, MacArthur's amendment would reinstate these benefits as the federal standard.

The amendment would also keep Obamacare provisions such as protections for those with preexisting conditions, keeping young adults on parents' plans until 26, guaranteed issue, guaranteed renewability of coverage, community rating rules, and prohibition of discriminating based on gender.

To keep premiums down and expand coverage, states would be allowed to obtain limited waivers from certain federal standards.

Diana Furchgott-Roth, a senior fellow at the Manhattan Institute, said the amendment does not solve the problems with Obamacare.

"I think this amendment would continue many of the problems of the ACA," she said. "Insurance companies should be able to offer the plans people want to buy. In many cases that means plans without certain coverage."

"Insurance companies need to have more flexibility in what plans they offer because that's one reason the cost of the plans is so high that you're required to offer all of these different types of coverage to people who might not want it," she said. "Why should people have to buy plans that cover maternity care if they won't have babies, or mental and drug abuse coverage if they think they won't need it?"