Join Club Momme for exclusive access to giveaways, discounts and more!

Sign up

The Looming Health Crisis In Half of All Pregnancies

Photograph by Twenty20

The American Health Care Act—the health care bill recently passed by the House of Representatives—is already mired in controversy. Democrats are wholly opposed to it. Many Republican Senators have expressed concerns about it. And the American people are left questioning what this potential law might mean for themselves and their families.

The AHCA itself is not without merit. Attempting to drive down insurance premiums for individuals and families is an admirable goal, as is attempting to drive down costs for small and mid-size businesses. But the ways in which the AHCA goes about this cost-saving could have dire consequences for parents and parents-to-be.

It could leave many parents and babies without insurance coverage for maternity and newborn care.

RELATED: Women and Kids Could Pay More For Healthcare Without Obamacare

This particular issue revolves around the state-based waivers that the AHCA makes possible. Under the Affordable Care Act (ACA, also colloquially known as Obamacare), maternity services are defined as essential health benefits. This means that insurers must include maternity and newborn care in their insurance coverage plans. (Prior to the ACA, 62 percent of individuals and families who purchased their own health insurance did not have maternity services included in their insurance plans.) But under the AHCA, individual states can apply for waivers that allow insurers to redefine or opt out of the essential health benefits that were delineated in the ACA.

Some governors are promising not to seek these and other AHCA-defined waivers. Nonetheless, their current promises don’t prevent future governors from seeking such waivers.

So, theoretically, states could apply for waivers that allow insurers to drop maternity and newborn care as essential health services. Thus, these insurers would no longer be required to include those services in their insurance plans.

[E]xcluding maternity services from the list of essential health benefits could have a profound negative effect on a profound number of people.

Some people might argue that if a young person (or any person, for that matter) doesn’t plan on getting pregnant, they should not be forced to purchase an insurance plan that includes maternity coverage and its associated costs. In other words, why pay for a service that you aren’t going to use?

But this argument fails to account for one crucial fact: namely, nearly half of all pregnancies in the United States are unplanned. In fact, according to the CDC, 49 percent of pregnancies in 2006 were unplanned—up from 48 percent in 2001. Moreover, between 2001 and 2006, the largest increases in unplanned pregnancies affected women with lower education and income, black women and unmarried women.

That’s millions of people whose pregnancies were unplanned. And it’s millions of babies born as a result of those unplanned pregnancies.

Millions of lives that change dramatically because of one unplanned circumstance.

RELATED: Politics of Affordable Healthcare: The Facts

As such, excluding maternity services from the list of essential health benefits could have a profound negative effect on a profound number of people—including that large group of people who weren’t planning on getting pregnant in the first place. And it’s easy to see how this might play out.

There are those who will argue that not mandating maternity coverage makes people “more free” to choose insurance plans that don’t include these services.

Let’s imagine, for instance, that a person lives in a state that has sought an essential health benefits waiver. Suppose, too, that, since they don’t plan on getting pregnant, they select an insurance plan that does not include maternity services coverage. It might be a comparably inexpensive plan, after all. But then suppose that this person (or their spouse) becomes unexpectedly pregnant. Since their insurance wouldn’t cover maternity services, they would likely be responsible for paying for the bulk of their maternity care. Those charges would vary depending on the person’s birth location and need for pregnancy testing and extra newborn care. Nonetheless, their out-of-pocket cost might very well total in the tens of thousands of dollars. Negotiating a lower fee with a hospital is often possible, but this doesn’t mean that the care itself comes cheap. It is often anything but.

Thus, despite the AHCA’s planned subsidies for maternity and newborn care—subsidies allocated for “high risk individuals”—it seems likely that we’ll see an increase in uninsured pregnant people if this bill passes the Senate. This is a terrible outcome for women, babies and their families.

There are those who will argue that not mandating maternity coverage makes people “more free” to choose insurance plans that don’t include these services.

But it also makes these people more vulnerable to catastrophic costs if they become unexpectedly pregnant.

And this is utterly unacceptable in a society where so many pregnancies are indeed unexpected.

More from news