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How Much Having A Preemie Could Cost Under The AHCA

As Americans grapple with the recent passage of the American Health Care Act in the House of Representatives, many are wondering what their insurance coverage will look like if the bill passes the Senate. Big changes could be coming, including for pregnant women. In particular, pregnant women and their partners could see a big shift in the cost of having a premature baby under Trumpcare, and not in a good way.

The problem largely lies in the newly-attached MacArthur Amendment, which would allow states to apply for waivers to dictate their own "essential health benefits," aka the benefits that insurance companies are required to cover. Under the Affordable Care Act, or Obamacare, maternity and newborn care are required benefits, but prior to those protections kicking in, 32 states and the District of Columbia did not require insurers on the individual or small group market to cover maternity care, according to data from the Henry J. Kaiser Family Foundation.

In short, those protections could disappear again if states are no longer required to provide them. And if women on the individual marketplace once again end up having to pay for their pregnancies out of pocket, costs could go up very quickly, especially with a premature baby.

March of Dimes Senior Vice President of Public Policy & Government Affairs Cynthia Pellegrini estimated in a statement to Bustle that the cost of having a premature baby could reach as high as $54,000. "It varies wildly based on geography," she said. "It's a very wide range... There are million-dollar babies out there."

Speaking of million-dollar babies, there's also the matter of lifetime limits on coverage. Giving birth to a premature baby could cost a lot on its own, but continued care for that baby could really cause costs to skyrocket, and the AHCA does away with important protections concerning lifetime caps, or how much an insurance company has to cover. No less an authority than the American Academy of Pediatrics spoke out against the AHCA, saying in a statement,

The bill also allows insurers to go back to putting annual and lifetime limits on coverage, meaning that a premature baby on private insurance could exceed her lifetime limit on coverage before she even leaves the hospital.

Vox wrote about one child, Timmy Morrison, who was born seven weeks early, just after the Obamacare ban on lifetime limits went into effect. His bills upon leaving the neonatal intensive care unit came out to around $2 million, but because his insurance policy could no longer cap his lifetime limit at $1 million like it had before the Obamacare regulations, his family was saved from bankruptcy, and Timmy could continue receiving the care he needed. If the AHCA passes, other families might not be so lucky.

The bill hasn't yet gone to a vote in the Senate, so there's still a chance to speak out against the ways in which Trumpcare would hurt the people — and babies — who need coverage the most.