Pregnancy Could Get a Lot More Expensive If Obamacare Is Repealed


Whatever you might think about Obamacare (the popular term for the Affordable Care Act), one thing is undeniable: It aimed to give women equal benefits under the law. Well, while America's women slept Wednesday night, the GOP-controlled Senate began the work of dismantling key provisions of the ACA. And, yes, the biggest losers if Obamacare is repealed will be women and mothers. It's time for all of us to wake up and pay attention, because we have the most at stake.


Obamacare's essential provisions include efforts to make the American insurance industry treat women more equitably in two key ways: It forces insurance companies to charge men and women the same amount for the same coverage, and it makes it illegal to deny women care for essential services like maternity care.

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There are wonks and wags of all political persuasions who will bore you to tears about the tools by which the government should, or should not, employ to bring about those changes, which generally range from single-payer "Medicare for all" to freer markets with less regulation. 

But it's hard to argue that women, based solely on their gender, should by default have to pay more to access basic health care than men. That's a no-brainer, right? It's discrimination.

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And make no mistake, before the ACA was passed in March 2010 and subsequently went into effect over time, many women were paying way more for less health care. It's a practice in the insurance industry called "gender rating," according to the National Women's Law Center (NWLC), and cost American women more than $1 billion per year -- and that doesn't even include the additional cost of maternity benefits.

According to the NWLC report card from 2010, only 14 states had laws that prohibited or limited insurance companies from charging women more than men for plans purchased on the open market. Gender rating has been prohibited in employer-provided plans for decades.

Adding insult to injury, on top of the gender rating practices, the NWLC found that in states that did not prohibit gender rating, only 3 percent of health care plans available on the open market, rather than from insurance provided by an employer, covered maternity care at all.

The ACA put an end to gender-driven pricing and, in addition, made it mandatory for plans to cover two important things for women and mothers: no-cost birth control and maternity and newborn care. Obamacare also made it illegal to consider pregnancy a preexisting condition, and therefore a reason to deny coverage. 

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Wednesday night the Senate voted down legislation that would have protected no-cost birth control and prevented discrimination against preexisting conditions (including pregnancy) -- leaving 55 million women without contraception coverage, according to New York magazine, not to mention the women who give birth to nearly 4 million babies in the US every year.

In 2007, before Obamacare was passed, the Kaiser Family Foundation did an analysis of the cost of maternity care and found that an uncomplicated, vaginal birth, with a standard two-day hospital stay at an in-network hospital, would run a mother anywhere from $1,455 under the most expensive plans to $7,884 under plans with the least amount of coverage. The most complicated maternity care, including extensive prenatal care for pregnancy complications like gestational diabetes, preterm labor, and a Cesarean section, could wind up costing a mother $21,194 out of pocket in 2007, Kaiser said.

And those figures don't include the cost of prenatal doctor visits.

Compare that with maternity care costs under the ACA's cheapest "bronze" level plans, which cap the out-of-pocket costs for maternity care at $7,150 as of 2017. Under Obamacare, insurance companies are required to provide women with access to "well woman" doctor visits, gestational diabetes screening, and well-baby care without a co-pay.

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Obamacare also mandates that insurance plans cover the cost of a breast pump, and breastfeeding support and counseling during the duration of time a mother chooses to breastfeed. Moms can say sayonara to those benefits too if Obamcare is repealed. When you consider that the latest next-gen "smart" breast pump, the Willow, retails for more than $400, that kind of coverage could be a huge help for new moms.

President-elect Trump and the Republican-controlled Congress have vowed to repeal and replace Obamacare, but there are no details on their plans and whether they will offer the same kinds of protections for women in the insurance marketplace as the ACA does. Women across the country have to watch and demand our representatives consider the damage women will suffer if they lose access to essential health care coverage.

And it's up to us to make sure they know. Call your representative, even if you hate Obamacare, and make sure they know what we need as they come up with a replacement. Congress is full of old, white men who for the most part probably don't give a lot of thought to epidurals and well woman visits. And until there are more women in those levels of government, the only thing we can do is make our voices heard from the cheap seats.

The repeal of Obamacare matters to all mothers, today's and tomorrow's. There are literally billions of dollars a year at stake for American women and millions of lives. Shame on all of us if we don't demand equal treatment by our legislators and the insurance companies who profit from our hard-earned dollars.

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