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Mar 23, 7:57 PM EDT

Will final health care deal match Trump's campaign pitch?


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AP Photo/Andrew Harnik

WASHINGTON (AP) -- With time running out to get votes for the Republican plan to repeal and replace "Obamacare," President Donald Trump has shown he's willing to make a deal. But could he wind up with a plan that doesn't line up with some other campaign promises?

As the tumultuous talks dragged on Thursday, one demand from lawmakers in the conservative Freedom Caucus was removing the federal mandate under Obamacare that insurers cover such basic services as prescription drugs, maternity care and substance abuse treatment.

Looking to win support, the White House offered to make the change, but the proposal irked some more moderate members and the future of the provisions remained fluid late Thursday night.

The prospect of changing those Affordable Care Act requirements drew criticism from Democrats and patient groups, particularly women's health organizations, who said such a move could impact people's ability to get health care plans that cover their needs.

White House spokesman Sean Spicer said that currently "people are paying for benefits that neither they, their spouse, their family needs."

Of course, people often don't know what they'll need an insurance plan to cover. To that, Spicer said: "I think if you're an older man, you probably won't need maternity coverage."

Trump himself has repeatedly promised to improve health care, including making some specific pledges, like better treatment for opioid addiction. Could changing the "essential health benefits," make it harder for him to deliver?

A look at some of Trump's health care promises:

OPIOIDS

During his campaign, Trump unveiled a plan to "to end the opioid epidemic" in the United States.

Addiction to heroin and opioids is at a nationwide peak, with 91 Americans dying from an opioid overdose every day, according to the Centers for Disease Control and Prevention. During the campaign, candidates stressed the issue, particularly on stops in states such as Ohio and New Hampshire, where overdoses have soared.

Under Obamacare, treatment for substance abuse and mental health must be included in plans that health insurers offer to individual consumers.

Karen Pollitz, a senior fellow at the nonpartisan Kaiser Family Foundation, said that before the health care law, one "of the categories that was routinely excluded was treatment for mental health addiction and substance abuse."

She said that without the requirement, "that would probably be the end of that coverage."

PRESCRIPTION DRUGS

Trump has been vocal about his desire to deal with the costs of prescription drugs. He promised to tackle it throughout the campaign. On Wednesday, he said he would work on it either in the health care bill or separately, but "we're going to bid down drug prices, and we're going to try to have the lowest prices anywhere in the world from really the highest."

If essential health benefits requirements were eliminated, people could end up with health plans that don't cover the prescriptions that they need.

QUALITY CONTROL

The president has long held that he will replace the Affordable Care Act with something better.

"I am going to take care of everybody. I don't care if it costs me votes or not," he said during an interview on CBS in September. "Everybody's going to be taken care of much better than they're taken care of now."

But critics said cutting the requirement to cover maternity care, emergency care and pediatric services don't match that promise. Organizations representing nearly 400,000 doctors sent a letter to congressional leaders early this year, saying any new health care legislation must ensure that "all health insurance products should be required to cover evidence-based essential benefits."

"We all have different health care needs and we have them at different times," Pollitz said, adding that without set benefits, plans will be like "an air bag that only covers half the car."

Spicer held that removing the requirements would benefit people, by putting "choice back in the marketplace."

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