Since the American Health Care Act made it through the House of Representatives earlier this month, there has been a lot of speculation about what might really go down if Republicans succeed in repealing the Affordable Care Act and replacing it with their very own health care bill. Understandably, women are most concerned about what kinds of changes the AHCA would make and if simple things they've taken for granted under Obamacare would now cost more. For example, will breast pumps cost money again under the AHCA?
It's likely they won't, which is good news, for now. But there are a few caveats. Pre-ACA, breast pumps and breastfeeding counseling for new moms weren't covered in many insurance plans. Obamacare mandated that those services were not just covered by insurance companies, but free, no matter what. Although the AHCA as it passed in the House (and any Republican-written health care bill, really) would likely affect women and children disproportionately, some staples, like birth control and breast pumps might be safe.
No-cost breast pumps and breastfeeding counseling are hugely popular among voters. Luckily for women, there's a tricky little rule that the GOP was working with when it came to approving the AHCA a few weeks ago called "budget reconciliation." That means that Republicans were faced with repealing every single ACA provision and facing a vote in the House that they couldn't win, or rolling back just a few of the regulations in Obamacare and passing the bill. They chose the latter, which is exactly why breast pumps (among other no-cost preventative services) might technically be safe under the AHCA.
The AHCA, and any health care bill written by the GOP-led Senate committee, will likely do two things when it comes to breastfeeding.
The first is that it will roll back Medicaid funding to states by some $800 billion over a few years, so that Americans on Medicaid might not feel the burn immediately — but within the decade, the bill would leave millions of Americans without healthcare. That would mean that lower income women won't have health insurance at all, or would have to pay hundreds of dollars out of pocket just for a breast pump to feed their infants. (By the way, formula is equally, prohibitively expensive).
The second thing the AHCA or any Republican health care bill will do is allow states to regulate whether or insurance companies have to cover certain pre-existing conditions. Pre-ACA, pregnancy was a pre-existing condition, so depending on what state women live in, a breast pump could be considered a medical expense one has to pay for as a result of having been pregnant.
Currently, the ACA is still the law, so every woman who needs one should be able to access a breast pump for free. And, because of budget reconciliation, any Republican health care bill might still cover some necessary services for women. For the moment, the only thing most women can do is cross their fingers, call their representatives, and hope for the best.