People actually wept yesterday, as Republicans in the US House of Representatives celebrated passage of the American Health Care Act (AHCA) as the replacement for the Affordable Care Act (aka Obamacare) or (ACA). While the white male vision of good health care for Americans hits many groups very hard -- the poor, children, veterans (as many as 8 million), older people under 65 -- it's generally agreed that the ACA once again makes being female a preexisting condition.

“This is a terribly bad piece of legislation,” Dr. Diane Horvath-Cosper of Physicians for Reproductive Health tells Bustle. “It was bad the first time they tried to bring it up to vote and weren’t able to, and the amendments they’ve added have not made an impact at all. For women, it’s the same bill as before, because it permits the same types of things — including basically not covering contraception.”

The AHCA will meet much stronger resistance in the Senate, where elected officials represent a significantly larger market of people -- even Republicans and Democrats. College-educated Republicans voted for Hillary Clinton; high-school degree Republicans voted for Trump. Theoretically, the Senate will be operating in the moderate middle -- even on the topic of the total defunding of Planned Parenthood, which once again raised its head in legislation.

Congressional Republicans -- 95% white men -- will tell you that once again the proposed healthcare bill says that insurance companies can't practice "gender rating", meaning that they must charge women and men the same amount of money for the same services. In reality, though, being a woman is a preexisting condition because the 10 "essential health benefits" that insurance companies must cover under the ACA (Obamacare) are no longer mandated.

Republican Men Say Babies Are Not In The National Interest

By 2020, American insurers would no longer have to cover the 10 mandated health issues currently covered by the ACA, with 8 of the 10 falling primarily on women.

Maternity and newborn care are one of the biggest medical expenses a woman faces in her lifetime. Presently, about 40% of babies in America are born out of wedlock. New research from sociologists at Johns Hopkins University and the University of Melbourne, analyzed in a July 2017 article in The Atlantic, found that babies born out of wedlock come disproportionately from young Americans who don't have college degrees, live in parts of America with large income inequality, and tend not to have a way forward in terms of job prospects in America. "The areas with the largest income gaps also tended to have the fewest medium-skilled jobs, which researchers define as jobs that only require a high-school diploma but still enable families to live above the poverty level—jobs such as office clerks and security guards."

By returning healthcare requirements to each individual state, Republicans easily make pregnancy a preexisting condition. If you want health coverage for pregnancy, it will cost you more money. Men argue this point all the time -- why must I underwrite a woman's pregnancy coverage -- when it's not my kid. This questions underscores two basic facts: 1) how many men hit and run in sex, leaving the woman to hold all the financial responsibilities; and 2) the larger civic issue of population growth. It's not as if men have no vested interests in America bearing children. What do they propose? Negative population growth for America?

Republicans Discourage Contraception

The answers to any of these problems are not overly simplistic, and Republican men make everything so so very easy to explain. Similarly, the AHCA doesn't specifically address contraception coverage, BUT on Thursday, President Trump signed an executive order on the subject of religious freedom that could very well affect heath care.

Unlike the ACA, which offered a series of compromise plans for ways to grant women contraception coverage when they worked for companies like Hobby Lobby who don't believe in contraception, a right granted to women by the US Supreme Court over 50 years ago, the AHCA sweeps the entire coverage under the rug. If conservative states want to legalize insurance policies that don't pay for contraception -- or abortion -- they will be able to do so.

Listening to Republicans advocate for no contraception coverage, you might think that only Democrats have premarital sex. Reality is often the opposite. Evangelicals -- the core of Trump's base -- have premarital or out-of-wedlock sex at rates equal to or greater than non-evangelicals. We addressed this reality five years ago, quoting this Daily Beast article:

It’s no secret that evangelicals have a big problem on their hands when it comes to young people and sex. The facts are staggering: despite almost universal affirmation that premarital sex is a sin, 80 percent of unmarried evangelicals (PDF) are having it, and 30 percent of those who accidentally get pregnant get an abortion, according to one survey. U.S. states where abstinence is emphasized over contraception in school sex ed—almost all in the heavily evangelical South—have teen birth rates as high as double (PDF) those of states with a comprehensive curriculum. Though an overwhelming majority believe premarital sex is wrong, white evangelicals are sexually active at a younger age than any demographic besides African-Americans, and are one of the least likely groups to use contraception.

The fact that true love isn’t waiting has concerned evangelicals for years, but the issue is gaining new attention because such a significant number of Christians' unplanned pregnancies end in abortion. The scramble to address the situation is revealing fault lines over the place of contraception in church practices, giving birth control a new centrality in the largely pill-friendly Protestant domain.

Prior to passage of the ACA, sexual assault was a preexisting condition, one that disproportionately affects women. Other medical conditions affected by the changes in the Republican plan include Cesarean sections, and postpartum depression.

Whittling Away Medicaid Assistance

The new proposal also severely impacts Medicaid recipients (government-sponsored assistance) who are primarily women in their childbearing years. This is particularly bad news, when the Trump administration is staffing its Health & Human Services agency with women executives who don't even believe in birth control.

Note that huge numbers of Medicaid recipients are working, but at low-paying retail or other service-industry jobs. The image of handouts to lazy women is an easy metaphor, but the reality of the situation is caught up in automation of high-paying jobs, union-busting, off-shoring and a lack of high-quality, marketable skills. The Republican cry "get a job" does not apply to this group of majority-women workers, many of whom work in minimum wage jobs, which can be as low as $7.25/hr, the federal minimum wage.

Abortion rates are now at their lowest rates since Roe v. Wade was enacted by the US Supreme Court. Planned Parenthood president argues that access to contraception is paying off. Anti-abortion activists argue that their influence is the reason. There is no argument that the rate of unintended pregnancies is dropping and America is seeing a historically-low abortion rate.

The Trump Administration clearly embraces the view protests against abortion clinics are the reasons for these encouraging numbers and US policy should be expanded to encourage anti-contraception coverage with the absurd argument that it will result in less sexual activity -- even among married couples. To that end, the Department of Health and Human Services is hiring up women who don't believe in contraception.

There is no doubt that Republicans led by President Donald Trump are in a full frontal assault against women's health. It's frankly mind-boggling that the same men who are voting to eliminate pregnancy insurance and prenatal care as expenses in the national interests -- ones that should be shared by society -- also want to cut off access to contraception.

The Republican War on Women never ended, but under President Trump it's once again a full-frontal attack. We profile two of the biggest new hires:

Greatest Female Crusaders Against Science, Contraception, Same-Sex Marriage & Reproductive Rights To Key Position At HHS

Charmaine Yoest, who was until recently president of the radical anti-abortion group Americans United for Life, will serve as assistant secretary for public affairs for America's Health & Human Services Agency. Yoest is a key perpetrator of the false claim that abortions cause breast cancer. When confronted by all the scientific research confirming no correlation between breast cancer and abortions, Yoest told Emily Bazelon in a 2012 profile for the New York Times Magazine, "Scientists are “under the control of the abortion lobby.” Writing for Slate, Christina Cauterucci breaks down the bad news.

Yoest’s new boss, Secretary Tom Price, is similarly opposed to abortion rights and contraception access, though he’s pursued his agenda as a legislator instead of an advocate. While Price will oversee policy shifts and enforcement, Yoest, as the department’s chief communicator, will be tasked with making any rollbacks of women’s health care go down easy for the general public. Supporters of women’s rights have reason to fear she’ll be frighteningly successful. “Though she has helped usher in hard-hitting changes in women’s health care, Yoest is especially good at sounding reasonable rather than extreme,” Bazelon wrote in 2012. “She never deviates from her talking points, never raises her voice and never forgets to smile.”

Teresa Manning Is Second Jawdropper Anti-Woman Exec Named By Trump To Direct Women's Programs

Politico reported on Monday that Teresa Manning will be named the Department of Health and Human Services’ deputy assistant secretary for population affairs, putting her in charge of more than $286 million in Title X family-planning grants. There is only one problem. Manning doesn't believe in the efficacy of birth control and is generally perceived as being like Trump's pick of Charmaine Yoest, in that she doesn't support the science behind women's reproductive health.

A former National Right to Life Committee lobbyist and Family Research Council analyst, Manning has accused the American College of Obstetricians and Gynecologists, a coalition of nearly 60,000 U.S. doctors and one of the most reliable sources of research and analysis on women’s health, of being deceitful and in the pocket of the 'abortion industry'.

Manning has opposed the use of contraceptives for years. “Teresa Manning has made a career out of denying women their right to reproductive health care services,” said Nancy Northup, president and CEO of the Center for Reproductive Rights, in a statement Monday. “It’s unconscionable and insulting that a vocal opponent of essential health care services has been tapped to lead the nation’s family planning program.”