GOP Health Care Proposals: Greater Flexibility means Unequal Care

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President Trump with Republicans following the House passage of the American Health Care Act. Photo: Wikimedia commons
President Trump with Republicans following the House passage of the American Health Care Act. Photo: Wikimedia commons

Health care is complicated. Who knew? Everyone but Donald Trump it seems. Since his election last year, Republicans have used their control of the White House, the Senate, and the House to try and push forward changes which would undermine benefits that everyone, no matter what state you live in, shares under Obamacare. These benefits include requiring all insurance plans to cover 10 essential benefits, no denial of coverage for pre-existing conditions, and children being able to stay on their parents’ health insurance plans until they are 26 years old.  

The healthcare proposals that have come out of the White House and the GOP Congress are framed as giving states more “flexibility.”  In reality, they would further divide the country by creating state-by-state disparities.  For example, a survivor of childhood cancer living in one state would be able to obtain health insurance as an adult but a survivor in the state next door might be denied coverage for the same pre-existing condition. We already have a situation in the United States where there are geographic and racial disparities in access to health care. The healthcare framework that Republicans are using will only serve to make those worse.

In 2012, I completed a 20+ year career as an officer in the U.S. Public Health Service. My background and training is in clinical social work. A portion of my career included managing the Emergency Medical Services for Children (EMSC) Program, a Federal grant program established in 1984. The U.S. Emergency Medical Services (EMS) system rapidly developed in the 1970’s, primarily to address cardiac arrest in adults and rapid transport for persons in motor vehicle crashes. What was overlooked in the development of our EMS system was the specialized needs of severely ill and injured children.  

The goal of the EMSC program is to try and make sure that the morbidity and mortality outcomes of severely ill or injured children are not dependent upon what state they live in; so, for example, a child injured in a car crash in Arkansas would get the same level of care as a child injured in a car crash in Maryland, or Georgia, or any other state. This program has seen success in improving the treatment of severely ill or injured children, yet most GOP health care proposals would likely turn back the clock  – especially in those states where Republicans control the governorship and the legislature – as these states would likely use their “flexibility” in a way that reduces the ability to get and receive care.

Congress has used the Affordable Care Act as the vehicle to reauthorize the EMSC program so a repeal of the Affordable Care Act would endanger this program and many others within the Department of Health and Human  Services. I use the underlying principles of the EMSC Program as an example of what ought to guide our health care policies. The White House and GOP controlled Congress are trying to take the nation into the opposite direction.

Donald Trump and his supporters love the “America First” slogan but their health care proposals say “Every State for Itself.” A true “America First” commitment would be that ill or injured persons of any age can have confidence that no matter what state they live in, there are some uniform guiding principles and benefits that govern the care they receive.

CAPT Dan Kavanaugh, USPHS, (Retired) is the immediate past-president of the 33rd Democratic Club. Dan is an actor and voiceover performer in the DC/MD/VA/PA area who also enjoys traveling, reading, and playing guitar. He and his wife Kim recently moved from Crofton to Annapolis where they enjoy taking scenic walks through the city.

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