Although Republican senators have said that the health care bill that recently passed the House will undergo significant changes before the Senate even considers it for a vote, the blueprint that the American Health Care Act laid out is frightening. In part, that's because it gives states the option to abolish current rules under the Affordable Care Act that require certain health services be included in all plans. The bill, also known as Trumpcare, would also lift the ban on the practice of jacking up insurance prices based on a person's medical history. As a result, treatment that many Americans have come to appreciate as a given for common medical phenomena under the ACA could get much more expensive. For example, treating postpartum depression under Trumpcare would change drastically.
Before President Barack Obama succeeded in passing the ACA (his signature health care legislation) during his first term in office, insurance companies could legally charge people with so-called pre-existing conditions more for coverage on the individual insurance market. What, exactly, qualified as a pre-existing condition varied from company to company, but they often included experiences that disproportionately affect women: sexual assault, domestic violence, pregnancy, cesarean sections, and, yes, postpartum depression. If the GOP-backed bill that the House narrowly passed May 4 were to become law, in its current form, companies in states that obtain waivers to allow them to do so would be free to reinstate this practice.
This means that although the companies would still be prohibited from denying someone with such a condition coverage outright, they could hike rates up in such a way to effectively price some patients out of the market. For example, economic analyst Steven Rattner projected recently that having depression could increase premiums by $8,490. States that do opt to go the waiver route would be required to create alternatives like high-risk pools for people who could no longer afford their insurance, but that could potentially offer little or no comfort for a person who has or has had postpartum depression: Premiums for people in high-risk pools could exceed $25,000 annually, a report from AARP stated recently.
The AHCA in its current form would also permit states to disregard the Affordable Care Act's "Essential Health Benefits" requirement. This provision of the law currently ensures that any insurance plan purchased on the individual market includes coverage for 10 "essential" services like preventive services, pediatric services, and emergency services. Also among the services that insurers would be allowed to tick off if the AHCA were to pass as is? Pregnancy, maternity, and newborn care and mental health care. That's a huge problem for people who require postpartum depression treatment after giving birth.
It's almost impossible to know how much money it would cost the average mom to treat her postpartum under Trumpcare, although Rattner's $8,490 premium hike figure is a good starting point. But we know for sure that the cost of not treating this serious condition that affects about 1 in 9 women can be great. According to Postpartum Progress, Wilder Research found that the lost income and productivity untreated depression can cause can cost an individual $7,200 per year. So, postpartum depression and related illnesses could cost the U.S. economy more than $1 billion every single year.
This isn't all about dollars and cents, though. It's about making sure that real people have access to the medical care that can save or maintain their health. Without that, America can't truly be great.