The Senate is currently rewriting the Better Care Reconciliation Act, its version of a health care bill that aims to repeal and replace parts of the Affordable Care Act. The ACA included provisions that ensured new parents could take their children to well-baby visits, get immunizations, and special screenings for autism at little to no cost. So how much will your kids' doctors appointments cost under the BCRA?
Right now, it's sort of up in the air. The draft of the bill that the Senate released last week was shut down by moderate Republicans and Democrats alike, delaying a vote until after the July 4 recess. So it still remains to be seen what changes they might make to the bill to make it more palatable to lawmakers.
Here's what families should know: It's likely that preventative care for children could get more expensive. The BCRA seeks to repeal fundamental ACA provisions such as essential health benefits, which means that neonatal care and well visits for children could end up being cut with the passage of the bill, depending on how each state applies the BCRA. Drafts of the American Health Care Act, the bill passed in the House of Representatives in May, would also repeal requirements for insurance companies to cover these essential preventative care benefits.
Many moderate Republicans and Democrats argued that the BCRA was harsher than the AHCA when it came to covering preventative care, so it's possible those benefits could make their way back into a bill after the recess in order to gain support for a vote. But nothing is certain.
If your family is under a group insurance plan through an employer, you might not notice any changes right away. The real costs will be passed onto lower-income families that might lose coverage through Medicaid or be priced out of buying individual insurance policies.
According to the Congressional Budget Office, an estimated 22 million people will be uninsured by 2026 under the BCRA. That means families that lose coverage, or those that were never able to afford it at all will end up paying out of pocket for most child health care services, including basic check ups for children. According to the American Association of Pediatrics, the first year of the recommended well-baby visits alone can cost more than $700, or about $95 each, without health insurance.
Many insurance companies will cover the cost of checkups for kids and teens if the family has insurance, but it depends on the plan. However, even those with insurance should take note: The BCRA gives states the power to advise insurance companies about coverage. The House bill gives the same power to states and insurance companies to do what's best for their own bottom line as well.
Also at risk are immunizations, which are usually covered by insurance, but could cost families about $620 extra on top of check up fees without it. And that's just for the first year. Checkups for toddlers and children later on could eventually cost more.
Donald Trump campaigned on an anti-vaccination platform; Considering his mandates concerning whether or not employers should cover health care like birth control, it's not crazy to assume that the administration would push to allow states and insurance companies to choose whether they cover immunizations at all, given how controversial they've become.
Leading up to the release of the revised BCRA, the only certainty is that people's health care situations, especially lower-income people, would change with the passing of any bill. And until the Senate releases a new version of its health care bill, families won't know exactly how much their children's basic health care will cost — which might be the scariest thing of all.