By now, you've probably heard that in a late-night session Wednesday, the Senate approved — by a razor-thin margin vote of 51 to 48 — a budget resolution that could quickly bring about the repeal of the Affordable Care Act, commonly referred to as "Obamacare." And with no clear replacement for it, many are left wondering what will become of their coverage and healthcare in the weeks to come. One question on the minds of many parents or parents-to-be is — how will the Obamacare repeal affect pregnant and new moms in particular?
Now, there are still several things that need to happen in order for Obamacare to be repealed entirely. The Senate voted on the matter on Wednesday, true, but the matter still needs to go before the House as well. That vote could happen Friday, and though it seems like most Republicans support the move and they have real strength in numbers in the House, passage there is not entirely guaranteed.
Then any repeal bill that passes both the Senate and the House would come before president-elect Donald Trump, who, while obvious about his support for repealing Obamacare, has also stated that he would want a replacement for the Affordable Care Act “very quickly or simultaneously, very shortly thereafter," according to the New York Times.
But if all of that does happen, how will a repeal impact expectant parents and new mothers?
Many insurance plans must let women seek care from an obstetrician-gynecologist without a referral from a primary care physician. According to NPR:
While the majority of states already had such protections in place, those laws did not apply to self-insured plans, which are the type often offered by large employers. The [Obamacare] health law extended the rules to all new plans. Proponents say direct access makes it easier for women to seek not only reproductive health care, but also screening for such things as high blood pressure or cholesterol.
A repeal of the ACA could change that, limiting options for anyone who needs OB-GYN care.
Under the Affordable Care Act, all insurance companies had to cover the costs of breast-feeding support and devices, such as pumps, without patient copayment. If Obamacare is repealed, it's unclear whether breast pump coverage will continue.
Additionally, the law requires employers to give women breaks at work to express milk for up to a year after giving birth, and to offer somewhere other than a restroom to go to allow for privacy. To paint a picture, "without the ACA, chest-feeding parents may be forced to return to crouching on a dingy toilet in a bathroom stall at work in order to express milk."
Under the Affordable Care Act, preventive health care is covered without cost sharing. Services such as screenings for breast cancer risk (like checking for the BRCA1 and BRCA2 genes), gestational diabetes and heart disease, as well as screening for human papillomavirus (HPV), and screening and counseling for HIV and STIs are currently available to patients at no-cost. Without Obamacare, these preventive measures may once more be financially out of reach for many, and many of them impact the health of women, children, and families as a whole.
Birth Control Accessibility
Access to birth control is important, and having affordable, available options is important for both parents and non-parents. Contraception allows people to better control when they have children and start families, if they want to at all, and to manage their family size.
Right now, with Obamacare in place, insurance plans have to cover birth control with no cost to the patient when provided in-network (although some religious employers and entities are exempt). If that law is repealed, birth control could suddenly become more costly and more difficult to get, according to CNN. This could seriously impact the family planning and reproductive decisions parents and those who don't have or want children make.
Coverage for Children
Under Obamacare, young people can remain on their parents' insurance until the age of 26. A change in this rule would have a clear impact on families and should concern parents or parents-to-be who are understandably invested in the health of their child or children.
Additionally, some families have additional health needs that the ACA helped cover care for. According to NPR:
Advocates for children with autism and people with degenerative diseases argued that many insurance plans did not provide care their families needed. That's because insurers would cover rehabilitation to help people regain functions they had lost, such as walking again after a stroke, but not care needed to either gain functions patients never had, such as speech therapy for a child who never learned how to talk, or to maintain a patient's current level of function. The Affordable Care Act requires plans to offer coverage for such treatments.
Without Obamacare, that sort of habilitative care may not be provided to families, individuals, and children who may need it.
Repealing Obamacare could have a devastating impact on parents and families. But it might not be too late.
Many people are sharing ways to make sure your voice is heard by our representatives, some taking to social media to do so. Like Michael Skolnik stated on Twitter, "ACTION: Save Obamacare! #SaveACA. Call your reps at 202-224-3121 and tell them not to repeal the Affordable Care Act."
Or you can look up your representative here. Call, tweet, show up in person if you can. Just make sure they know: repealing Obamacare could hurt families, and you want them to vote "no" on a repeal without a back-up plan.