President Donald Trump and the Republican Party suffered a huge defeat on Friday when House Speaker Paul Ryan withdrew the American Health Care Act before it could come to a House vote. Despite intense internal lobbying to some of the most conservative members of the GOP, the beleaguered health care bill would not have had the votes it needed to pass. As it stands, the Affordable Care Act remains the law of the land. So what does this mean for moms-to-be, and how much will pregnancy cost under Trump?
There's no clear cut and dry answer to that question, despite the failure of the ACHA on Friday. How much pregnancy will cost in a Trump Administration comes down to one issue: The Affordable Care Act. Even though it's back as the de facto law since the ACHA was withdrawn, the ACA isn't perfect. Given that health insurance carriers have until June 18 to decide whether or not to participate in the ACA exchange — when enrollment for 2018 begins in November of this year — the cost of pregnancy could change dramatically in as few as three months from now.
If you are pregnant, or thinking about getting pregnant in the foreseeable future, there are two possible scenarios to consider when calculating your potential pregnancy costs.
If Nothing Happens To The Affordable Care Act
The best case scenario for pregnant moms trying to determine pregnancy costs is if nothing happens to the ACA at all, where Trump, Ryan, and the GOP try to focus on other policy areas with their tails tucked between their legs on health care. Under the ACA, maternity care is an essential health benefit, which means insurers must provide coverage for anything related to maternal health.
Providing coverage of course doesn't mean moms-to-be won't have to pay for various aspects of maternity care, but at least under the ACA, those costs are typically lower, such as co-pays, deductibles, and co-insurance. While prenatal visits no longer require co-pays, some families must pay a deductible (upfront out-of-pocket cost) or co-insurance (percentage of total cost) for birth and delivery. Those individual costs for deductibles and co-insurance varies by insurance plan and carrier.
If The ACA Is Repealed, Replaced, Or Changed
In this scenario, it all depends on whether or not provisions for essential health benefits, pre-existing conditions, and the individual mandate remain in whatever health care replacement bill makes its way to Trump's desk for signature. What we can surmise is this: If the pre-existing condition and essential health benefits provisions are removed, pregnant women and women who become pregnant are going to get royally screwed into paying far more for coverage because, prior to the Affordable Care Act, pregnancy was considered a pre-existing condition upon which insurers could deny coverage, leaving some women to buy outrageously expensive maternity riders instead.
If the individual mandate is removed, then Americans aren't required to have health insurance — and in that instance, costs for pregnancy and birth skyrocket, since they would be paying out of pocket for every cost and fee associated with pregnancy, from routine appointments and screenings. This definitely adds up: Ultrasounds can cost anywhere from $500 to over $1,000. What's more, giving birth without insurance becomes exorbitant: Uncomplicated vaginal births can cost as much as $30,000 and c-sections can cost upwards of $50,000 or more, according to a 2010 report by research firm Truvent Analytics.
The Bottom Line
There's no way of getting around the fact that having a baby costs money. But as for the cost of having a baby in Trump's America, that number has the potential to vary widely based solely on the political whims of his administration.