Sunday, June 11, 2017

Trump Administration Is Proposing a Giant Step Backward for Women's Health

Ian and I at a pro-choice rally
April 5, 1992
Half of pregnancies in the United States are unplanned. Maternal mortality is rising and much higher in the U.S. than in comparable countries like Canada and the United Kingdom. Maternity care and childbirth cost more in the U.S. than in the rest of the developed world. Yet, we are still debating whether or not health insurance should cover birth control and maternity care.

The Trump administration recently announced plans to roll back an ACA provision requiring insurers to cover birth control and the American Health Care Act would allow states to opt out of covering maternity care. Prior to the ACA, only nine states required maternity coverage and only 12 percent of plans available in the individual market place included benefits for maternity care. [Statistics from: How Obamacare changed maternity coverage.] Similarly, the Kaiser Family Foundation reported three in four non-group health plans did not cover delivery and inpatient maternity care in 2013, before the ACA was enacted.

Instead of working to address the reasons behind appalling statistics like this, the Trump administration is trying to set us back even further.
In 2005, 23 US mothers per 100,000 live births died from complications related to pregnancy or childbirth. In 2015, that number rose to 25. In the United Kingdom, the number was less than 9. In Canada, it was less than 7. ~JAMA
There are many options for long acting reversible contraceptives available today, but some cost upwards of $500. It's a small expense in a health plan--especially when compared to maternity care and child birth which can easily hit $20,000. However, $500 out-of-pocket is out-of-reach for many young women. (Despite Tom Price suggesting all women can afford birth control.)

There is a definite link between unintended pregnancy and poverty. Medicaid paid for 68% of the births resulting from unplanned pregnancy. This makes it a public health issue that effects us all. Unplanned pregnancies cost taxpayers $21 billion dollars each year. Since the Accountable Care Act went into effect, the rate of unintended pregnancies has dropped and the abortion rate in the U.S. has fallen to the lowest level since Roe vs Wade went into effect. This progress is about to be undermined. 

The proposed regulation can go into effect as soon as it's published in the federal register. Typically, there would be a notice and comment period, but the Trump administration wants to bypass that process and have it go into effect immediately. In this way, the executive branch could set us back without any help from congress and without any public involvement. Some states are beginning to take action putting birth control on the legislative agenda, but allowing employers and insurers to opt out as the Trump administration is proposing is a giant step backward. 

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