There's no question that the Affordable Care Act introduced under former President Barack Obama has always had its fair share of weaknesses: Republicans often criticized the rising premiums and the lack of competition among insurance companies as proof that the system needed to be overhauled, and President Donald Trump largely ran his campaign on the perception that Obamacare was a failure that needed to be immediately scrapped. On Thursday, the House passed the GOP's health care replacement bill, and now, it looks like voters should brace themselves for increased costs. Here's how much more pregnancy will cost under Trumpcare, because the American Health Care Act will once again make having a baby a pre-existing condition.
According to The Independent, ahead of Thursday's vote, Trump said that the AHCA wouldn't negatively affect Americans with pre-existing conditions, and that his health care plan “will be every bit as good on pre-existing conditions as Obamacare." House Speaker Paul Ryan echoed that sentiment, claiming that the AHCA would “lower premiums while keeping protections for the most vulnerable in place." But will it actually? A recent analysis from the Center for American Progress suggests that the so-called "Trumpcare" plan would likely result in "premium increases of tens of thousands of dollars" for those with more complicated health histories.
One reason, according to The Independent, is that the latest Trumpcare amendment would allow insurance companies to charge those with pre-existing conditions more for coverage. Under Obamacare, insurance companies had to charge the same premium regardless, which meant that Americans who had formerly been unable to either qualify for or afford health insurance because of their medical issues could finally be able to access and maintain coverage. But in an effort to cut costs, the AHCA will allow states to waive that requirement, giving insurers the ability to charge higher premiums to those with higher health care costs.
But even if you agree that insurance companies should be able to charge higher premiums for sick people, you might not exactly be pleased to realize that under the AHCA, pretty much everything can be considered a pre-existing condition. And the increases can be staggering: according to the Center for American Progress, even when the GOP's risk sharing program is taken into account (something which would lower premiums for high-risk individuals by about 1.5 percent), insurance surcharges for pre-existing conditions will easily be thousands of dollars.
Perhaps unsurprisingly, serious conditions like cancer will likely result in the biggest increases — anywhere between $28,000 to more than a whopping $140,000, according to the Center for American Progress. Have uncomplicated diabetes? Expect to pay an estimated additional $5,500. Those with mental illnesses like depression and bipolar disorder may be looking at a surcharge of around $8,000, while those with asthma might end up paying as much as $4,000 more. And even if you are otherwise totally healthy, but are pregnant and require coverage for prenatal care and your delivery? Even without any complications, a completed pregnancy could result in an estimated surcharge of around $17,000.
Unsurprisingly, the ACHA isn't particularly popular among those who provide these necessary services to women. In an op-ed published Wednesday on Syracuse.com, the American Congress of Obstetricians and Gynecologists' Dr. Leah Kaufman wrote that the ACHA would be "a disaster for women, especially those who have been pregnant or want to be pregnant." While Republican politicians might believe that the ACHA will be an improvement over Obamacare, Kaufman argued that, in reality, it would be extremely detrimental:
The simple fact is, the American Health Care Act would take us back to the days when women were routinely charged exorbitant premiums because insurance companies decided being pregnant or being a survivor of domestic violence was a pre-existing condition.
Under the new repeal bill, a pregnant woman could be charged more than $17,000 per year for coverage and a woman with breast cancer could be charged more than $28,000 per year. What kind of insurance is that?
What's more, Kaufman noted, is that the ACHA will also allow states to do away with the Obamacare requirement ensuring that coverage for prenatal, pregnancy and infant care is guaranteed as an essential health benefit. According to Healthcare.gov, all ACA insurance marketplace and Medicaid plans must cover pregnancy and childbirth, even if the pregnancy began before the approved coverage date. But without that requirement, Kaufman argued that it would likely result in a massive lack of necessary coverage for pregnant women:
Also appalling, millions of women could lose maternity coverage. Today, all health plans must cover maternity care. The repeal bill would gut these and other coverage standards, bringing our nation back a decade to when only 12 percent of health plans covered maternity care. Approximately 13 million women stand to lose maternity coverage under this bill. Like a decade ago, insurers would also be allowed to not cover Cesarean sections at all or charge women a 25-percent premium surcharge for this coverage.
Unfortunately though, that hasn't seemed to be much of a concern to the president, who praised the bill's passing as a major win. According to CNN, Trump spoke following the vote and said, "[the American Health Care Act] is a great plan. I actually think it will get even better. This is a repeal and replace of Obamacare. Make no mistake about it."
In a video of the press conference, which the president shared on his Twitter account, Trump said that Americans had been "suffering so badly with the ravages of Obamacare," and claimed, "as far as I'm concerned, your premiums are going to start to come down [under the AHCA]." Arguing that deductibles under the ACA "were so ridiculous that nobody got to use their current plan," Trump said, "most importantly, yes, premiums will be coming down, yes, deductibles will be coming, but very importantly, it's a great plan, and ultimately that's what it's all about."
Of course, given that, for many Americans — and particularly for many American women — that probably won't actually be the case, it seems that perhaps when making those comments, he was only really speaking to the large group of middle-aged white men standing behind him in the Rose Garden. Because while the American Health Care Act might lead to a reduction in government costs related to health care, it certainly doesn't appear as though it will be a plan that will make health insurance affordable and accessible for all Americans (or even most of them).
Aiming to create a health care plan that would improve upon the weaknesses of Obamacare really could have been an admirable endeavor. But the plan the GOP has actually come up with doesn't actually appear to do that. Instead, it seems to have reintroduced policies that will unfairly discriminate against people with health problems, as well as those who require medical care that should seem fundamental (it's not like any woman in labor can opt out of delivering her child, so charging her more for having to do it should seem preposterous). Yet, if the bill does indeed pass through the Senate, that might be exactly what Americans are going to get.