Thursday News: Unhealthy developments

CONSERVATIVES WANT PREGNANT WOMEN AND VERY ILL REMOVED FROM INSURANCE COVERAGE: In a count by The Associated Press, at least 25 Republicans said they opposed the current House attempt at a health care overhaul, and others were leaning that way, enough to narrowly defeat the measure. The number was in constant flux amid eleventh-hour lobbying by the White House and GOP leaders. Most opponents were conservatives asserting that the GOP legislation demolishing former President Barack Obama's health care law did not go far enough. They insisted it must repeal the law's requirements that insurers pay for specified services like maternity care and cover all comers, including the sickest, which they say drive up premiums.

ACA REPEAL WOULD CUT FUNDING FOR IMMUNIZATIONS AND HIV TESTING: Free immunizations, HIV tests and other health services provided to North Carolinians through federal funding would disappear in the Republican plan that Congress is expected to vote on Thursday to replace the Affordable Care Act. The Prevention and Public Health Fund, embedded in the ACA, directed $17.2 million to North Carolina this year for a range of public health programs, many of them free. Congress has not proposed a replacement for the fund, creating uncertainty on federal funding for state health laboratories and other health programs that were rolled into the ACA in 2010.

REPUBLICANS MAY CUT OTHER "ESSENTIAL BENEFITS" IF NECESSARY: The ACA's "essential benefits" include outpatient care, emergency services, hospitalization, pregnancy, maternity and newborn care, mental health and substance abuse treatment, prescription drugs, rehabilitation, laboratory and diagnostic tests, preventive and wellness services, and pediatric care, including dental and vision services for kids. The required benefits are considered especially significant for women, since birth control and other routine women's health services are now covered at no charge to patients. Some White House officials have also acknowledged privately that essential health benefits are among the list of potential changes under discussion. While declining to elaborate on specifics, spokeswoman Sarah Huckabee Sanders said, "We're open to changes that help make the bill better."

FOLWELL RAISES PREMIUMS FOR STATE EMPLOYEES' HEALTHCARE PLANS: The health insurance plan for employees and teachers that now carries no premium is going to cost $25 a month next year under a package of changes to the State Health Plan its board of trustees approved Wednesday. Retirees enrolled in this basic plan would continue to pay no monthly charge. The decision came despite objections from some groups representing teachers and retirees who said rising health-care costs are hurting their members, some of whom have not had raises or cost-of-living adjustments that have kept pace with expenses. Mark Jewell, president of the N.C. Association of Educators, said premium increases will make it harder to recruit and keep teachers. “Out-of-pocket costs for health care have increased for our members, while they have seen little in the way of pay raises, especially our most experienced teachers,” he said.

ROSE HOBAN: DISABLED KIDS FACE SEVERE CUTS TO SERVICES UNDER REPUBLICAN PLAN: Nell’s 5-year-old daughter Lydia is a child who is “medically fragile.” Born prematurely, Lydia developed a dire complication necessitating the removal of close to 80 percent of her intestines. Lydia is able to run and play like other preschoolers, but she dependent on almost continuous nutrition via a feeding tube that she carries around in a flowered backpack. If she gets even a little bit dehydrated, or if she gets overheated, it’s off to the hospital. The Nells receive home health services from a Medicaid waiver program that provides access to a nurse and other supports. The program providing care and services for Lydia is an optional one. “When lawmakers go in to cut stuff in Medicaid, historically, they’ve gone to programs that are optional,” she said. The Congressional Budget Office estimated Medicaid would shed at least 14 million beneficiaries by 2026.