Brain Injury Coverage as an Essential Benefit AHCA

Emergency Alert: Calling All Brain Injury Advocates

UPDATED 3/27

The U.S. House of Representatives did not vote on the proposed AHCA bill. Due to an apparent lack of votes for passage, the bill was pulled by Speaker of the House Paul Ryan prior to the vote.

Whether or not new legislation on healthcare will be introduced in the future is unknown at this time, but we’ll keep you informed. We at Pate were touched with how many of you contacted us to say you’d reached out to your representatives to advocate for essential health benefits for people with brain injuries and people in general. Thanks for taking the time to let us know your interest in the topic and for getting involved.

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Our friends and partners at the Brain Injury Association of America sent an emergency call for all people touched by brain injury to get involved in protecting essential health benefits.

Many lives could depend on you picking up the phone.

The U.S. House of Representatives is poised to vote on the American Health Care Act. The latest development is a push to eliminate essential health benefits (EHB) requirements in the private market.

This would have a devastating impact on people living with brain injuries.

We Need Your Help!

If this amendment passes, many insurers would once again exclude services based on pre-existing conditions, preventing many people living with brain injury from getting the care they need for ongoing, pressing health concerns.

EHB includes many services that people living with brain injury depend on. Think about a family member trying to get better without a policy that covers basics such as outpatient care, emergency services, hospitalizations, maternity care, mental health and substance abuse disorder services, prescription drugs, rehabilitative services, laboratory services, preventive services, and pediatric services.

 

Get Involved and Call Today 

It is vital that individuals with brain injury and their families/caregivers/providers make it clear to their representatives today that it is unacceptable to strip these minimum consumer protections out of the health insurance market.

The House intends to vote on the American Health Care Act, potentially with an amendment to repeal EHB. Advocates can dial 1-866-426-2631 (English) or 1-877-736-7831 (Spanish) to be connected to their representatives.

This is a sample script that can be used:

Hello my name is _______ and I live in [city, state]. I am a person [living with a brain injury/concerned about individuals with brain injury]. I am calling to demand that you vote against the American Health Care Act. I also urge you to vote against any amendment that would remove critical consumer protections like essential health benefits. The American Health Care Act will hurt people living with pre-existing conditions by making it harder and more expensive to get the care they need. All Americans deserve better. I urge you to support the 5.3 million individuals living with disabilities as a result from a TBI and oppose the American Health Care Act.

Call Now! Don’t Wait!

 

 

What Life Was Like Before the ACA

Prior to the Affordable Care Act, many insurers in the individual market avoided covering these services, with 62% of insurers omitting maternity coverage, 34% omitting coverage for substance use disorder treatments, and 9% omitting prescription drug coverage. If this amendment passes, many insurers would once again exclude services based on pre-existing conditions, preventing many people living with brain injury from getting the care they need for their most pressing health care concerns. Insurers would likely also purposefully choose to offer poor benefits in order to attract healthy enrollees while discriminating against people living with brain injury.

 

Why Pate is Involved

“Part of Pate’s mission is to advocate for people with brain injuries,” said Marilee Hayden, one of Pate’s Vice Presidents and the daughter of founder Dr. Mary Ellen Hayden. “This includes advocating for reasonable and affordable access to healthcare.  The House is considering eliminating essential health benefits, which includes rehabilitation services.  Lack of rehabilitation could mean that more people with brain injuries would not be able to return to work or take care of themselves.  Importantly, this would reduce the quality of life for these individuals.”

 

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