Lots of questions, controversy, and uncertainty has resulted from the Trump administration’s proposed replacement to Obamacare, also known as the Affordable Care Act. Under President Trump’s proposed health care act, entitled the American Health Care Act, federal stipulations on funding and coverage would be rolled back, potentially reducing coverage to Americans in need and raising expenses.
GOP Congressman John Shimkus from Illinois has been a vocal advocate of the American Health Care Act. He publicly denounced Obamacare’s individual mandate, claiming it was preposterous for men to be charged for maternity and pregnancy insurance, since they can’t directly tap into the benefits of such coverage. This statement in particular has ignited a debate among legislators and their constituents about the very purpose of taxes and the logistics of health care coverage.
Maternity insurance was named as one of the ten essential areas of coverage former president Obama included in his healthcare bill in 2014. Usually, maternity or pregnancy policies will help cover or defray the costs of prenatal care, delivery, recovery, and outpatient services. These policies will often also cover counseling for lactation, postpartum depression, and other conditions that accompany childbirth. As per the ACA, insurance companies had to cover pregnancy and maternity.
Congressman Shimkus argued in March that it was silly for men to have to chip in for maternity insurance, since to his knowledge, no men had ever given birth. The video footage of his observing this before Congress went viral, with some lauding his bravery and others accusing him of undermining essential reproductive rights and coverage.
While the congressman technically correct, the function of insurance is not necessarily to cover only what one person needs. For health insurance specifically, costs per person are calculated by pooling risks and divvying up the “average” cost among everyone with a plan. In the end, everyone winds up paying for some coverage they don’t need, but by the same token, they pay less for the coverage they do need. A woman, for example, may very well take advantage of pregnancy coverage, but will likely never need to purchase viagra or be treated for prostate cancer.
Those opposed to the ACHA have called on the heartlessness of those who want to opt out of paying for insurance that will benefit the “greater good,” comparing Shimkus’ proposal to someone asking to be exempted from taxes that help build a bridge the individual will never use in their lifetime. However, as we have discussed elsewhere, insurance is, in fact, an industry. While maternity insurance does help defray the cost of hospital births, it can urge women away from seeking a more cost-effective form of prenatal care including midwives and doulas.
If the ACHA passes as it’s written, maternity insurance would no longer be covered by the vast majority of insurance providers. Most standard healthcare policies do include childbirth, but not all of them.