Hey, Republicans, you missed something in "repeal and replace"

Hey, Republicans, you missed something in "repeal and replace"

After years of promising to "repeal and replace" the Affordable Care Act ("ACA" or, "Obamacare"), the Republicans finally came up with a scheme to amend a few provisions. Called the "American Health Care Act," ("AHCA," but not "Trumpcare," apparently), it has been widely criticized by both the right and left, and just about everyone else, for that matter. (The Kaiser Family Foundation has a nice chart comparing the ACA, the AHCA and other proposals if you want to learn more.)

Ever since the distant possibility of "repeal and replace" became a disturbing reality last November, I've been wondering: What will happen to Section 2706 of the ACA?

What? You don't remember Section 2706?

Section 2706 is the "non-discrimination in health care" provision of the ACA, which says:

"A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider's license or certification under applicable State law."

The provision was dropped into the law by former Sen. Tom Harkin, with no discussion or debate, at the behest of one of his most infamous constituencies, enthusiasts of so-called "complementary and alternative medicine," of which he is a devotee. Sen. Harkin was also instrumental in the creation of the National Center for Complementary and Integrative Health (formerly, National Center for Complementary and Alternative Health), which he famously criticized for failing to "validate" alternative medicine.

Section 2706 was rolled out to much fanfare by CAM enthusiasts, who thought it would mean instant coverage of their quackery. As American Association of Naturopathic Physicians functionary and Vermont naturopath Loirlee Schoenback, sunnily predicted:

"If the law is implemented as intended NDs in 16 states [where they were then regulated] will immediately be covered by insurance."

"Implemented as intended," Schoenback said,

"suggest[s] that if insurers cover a health condition, they must pay any providers are licensed to treat that condition. If the insurer covers a service provided by medical doctors . . ., for example, it must also cover that service when provided by another legal provider, such as NDs, acupuncturists or chiropractors."

Whether this is what Congress intended or not, fortunately, it hasn't happened. Insurers are still excluding quackery from coverage, for obvious reasons. No health insurer wants to pay for ineffective treatments, which is why companies like Aetna expound at length, for example, on the many forms of chiropractic pseudoscience they will not cover. And it is why CAM providers still badger legislators to force public and private insurers to cover their services, sometimes successfully.

So, is Section 2706 out? Did the Republicans kick it to the curb? Nope, unfortunately, it's still there. I'm more of a single payer person myself, but if Congress is going to repeal the ACA and let the "free market" take care of business, then I'm all for letting chiropractors, naturopaths and acupuncturists sink of their own accord, free of the artificial supports that help keep them afloat. It's bad enough that the states allow naturopaths, chiropractors and acupuncturists to prey on the public via practice acts that legitimize quackery. Just don't make the rest of us pay for it through insurance premiums and taxes.


Points of Interest 03/13/2017
Points of Interest 03/11/2017