Just because Senate Republicans have slapped a brand new name on the House version of Trumpcare certainly hasn't made it any better for Americans. The Better Care Reconciliation Act is basically the same exact health care bill as the American Health Care Act, with a few differences to appeal to moderate Republicans in the Senate. Even so, there is still one part of the new health care bill that is horrible for moms and babies — and with a Senate vote on the BCRA likely to happen later this week, Americans could be mere days away from a potential health care disaster.
One of the many issues of contention with the Senate version of the health care bill is lifetime caps. What are lifetime caps? They are limits set in place by health insurance companies over the life of someone's health care coverage. Essentially, health insurance companies were free to limit exactly how much money they could cover per person over the lifetime of their coverage — well, they were free, anyway, until the Affordable Care Act became law in 2010. Both the House and Senate versions of the health care bill seek to roll back the ACA restriction on lifetime caps for states because somehow, this makes health care cheaper — unless of course you're a person with a chronic condition, or worse — your child has significant medical issues.
There have been many parents sharing the stories of their children's medical care expenses, and how lifetime caps will endanger children's lives. As a parent, it's understandable that kids get sick. Sometimes I remain convinced that kids have a special gravitational field just for germs — but I digress. But there are also plenty of kids who aren't catching colds at preschool or soccer practice: Children born with congenital issues that require substantial medical treatment. As frustrating as office visit co-pays may be for all those cold and flu visits, parents of children with serious illnesses and conditions face far greater out-of-pocket expenses — and even more so, should lifetime caps come back.
With lifetime caps back in place, health insurance companies are allowed to cut off coverage once that lifetime cap dollar limit has been reached. If lifetime caps are allowed under the BCRA, health insurers are well within the law to tell any patient: Hey, you're too expensive to cover anymore — so, you're sh*t out of luck on getting any more money from us. Good luck with paying for the rest of your treatments for childhood cancer.
I'll add my own story to just how bad lifetime caps can be. My son was born five weeks premature. He was a hard won baby, after a devastating infertility diagnosis made IVF or adoption our only means to build our family. Just bringing our little dude into existence set us back $27,000 out of pocket — and that was with insurance in a state with the best infertility coverage. My son came into this world on his own terms five weeks early — and then nearly died five days after birth. He spent 29 days in the NICU fighting for his life.
I still have the hospital bill for those 29 days. His hospital bill included the cost of labor and delivery, his many x-rays, blood tests, the monitoring equipment, the antibiotics, the neonatologists who ordered his care, the expensive special formula that kept him fed because breastmilk wasn't going to cut it. All told, my son's NICU stay was billed at $325,000. Amazingly, we were responsible for a $1,000 deductible — that's it.
I shudder to think what lifetime caps would have meant for his care. And that was just for 29 days: Imagine if a child has a serious chronic health condition, such as childhood cancer, congenital heart disease, or cerebral palsy. It's disturbingly easy to hit a lifetime cap of $1 million in just a matter of months of treatment and care. That's what makes lifetime caps particularly sinister for families: No one should have to make choices that could affect their child's life because of an inability to afford care.
