My sister has breast cancer.

While Republicans were meeting in closed door sessions with Speaker Ryan and Donald Trump, trying to figure out a way to gut health care for Americans, my sister was undergoing the genetic testing for the BRCA gene. The test costs $4,000. We aren’t sure yet if her insurance will cover the test or not.

We need the answer to the test because my aunt and my uncle have had breast cancer. Since they are siblings that throws my sister into the high risk category for the BRCA. If her insurance pays for the test, and the test confirms the family for BRCA, that affects me, my brother, all of our children and our cousins and their children.

While all of this is going on, Republicans legislators, who have the best medical coverage taxpayers can afford, have devised ways to treat insurance plans like a banana split, letting people pick and choose the toppings they can afford. Why should I pay for mammograms? some of the Senators have asked. I’m a man. I don’t need mammograms, pap smears. I don’t want to pay for yours.

Thing is they can get breast cancer, too, especially if their family is confirmed for the BRCA.

Not only does my sister have breast cancer, but my niece was diagnosed about the same week as my sis with cancer. She began a six-month regime of chemo this week. She’s in her 30s. Thankfully, she lives in an urban area and has insurance and access to great medical care,  still there were all sorts of mishaps. An inconclusive biopsy that had to be repeated. Snow and ice delays. Puzzling lack of symptoms that would typically accompany such a disease.

I wonder if the Republicans had their way if my niece would have been covered for that second biopsy that confirmed the cancer, or if under the Republican’s plan such a procedure would have been ruled extravagant.

Trump and Ryan are so intent on punishing the poor for being poor and rewarding the rich for being rich that they are threatening legislators to pass their health care bill, or else…

And because Trump touts himself as the negotiator – his term for being the biggest bad ass bully on the block – he and Ryan have even agreed to the most right-wing contingent of the party to eliminate what have long been considered “essential health benefits”.  In case you are unfamiliar with essential health benefits, here’s a run-down:

• Outpatient care — This covers most scheduled doctor visits, such as to check a rash, or a non-emergency stomach ache. Insurance companies negotiate deals for these and often designate “networks” of doctors and clinics with approved charges. Individuals who walk in without coverage pay much, much more.
• Emergency room trips — Insurance policies cover both the ER visit and ambulance trips. Otherwise people can get socked with bills totaling tens of thousands of dollars, perhaps incurred while they were unconscious.
• In-hospital care — All care people get as hospital patients, such as surgery. Some conservatives argue that people should be able to choose to opt out of this type of coverage and pay lower premiums. Most health policy experts say this is a gamble. “One answer is because someday you may be sick and that’s the way that insurance works,” says David Cutler, a Harvard University economics professor who helped design the Affordable Care Act.
• Pregnancy, maternity and newborn care — This one’s controversial to some, who ask why men should pay for a service they’ll never use.
• Mental health and substance abuse disorder services — This particular benefit has gotten some attention with the ongoing opioid epidemic.
• Prescription drugs — Insurance companies usually negotiate discounts. Out of pocket costs for many drugs can be much higher than what an insurer pays for them.
• Rehabilitative services and habilitative services. These include help recovering from an injury or illness, but also treatment for kids with autism or cerebral palsy.
• Lab tests
• Preventive services — This includes vaccines, cancer screenings such as mammograms and colonoscopies and, controversially, coverage of birth control.
• Pediatric services — Including dental and vision care for children.

Looking at this list it makes you wonder, what’s the point of insurance that isn’t required to cover the essentials, huh?

Men, there are a bunch of us women out here wondering why you aren’t raising your voices loudly in unison against Trump and Ryan on this.  While it is true you can’t get pregnant, you can’t father a child without help from a woman. And while it’s true you won’t ever get uterine cancer, doesn’t mean that a woman you love won’t. And while, yeah, breast cancer typically affects women, men are not immune from it.  One in eight women will suffer breast cancer. One in a thousand men will as well.

If the Republicans are able to gut the essential health benefits as Trump and Ryan have suggested, you can bet that the insurance coverage you currently have is going to be affected as well.

And while I understand the need for health care/coverage reform in this country, I don’t think this is the path the wealthiest country in the world should be pursuing.

These decisions are affecting somebody’s loved ones.

Maybe your own.

Karen Spears Zacharias is author of BURDY and the forthcoming CHRISTIAN BEND (Mercer University Press).