The Supreme Court could eliminate the Affordable Care Act after the presidential election in November. If you're a mom, that might make health care more expensive for you and your family.

By Lisa Milbrand and Melissa Mills
Updated September 30, 2020
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When you talk about “preexisting conditions,” you probably think of things like diabetes, heart disease, and cancer. But the reality is that health care companies consider a whole slew of common health concerns preexisting conditions. Odds are, if you’re a mom, you possibly already have one of them: having been pregnant.

Now, with the 2020 presidential election fast approaching and the Supreme Court scheduled to hear a case on the Affordable Care Act (ACA)—aka Obamacare—in November, the health care of millions of Americans could soon be affected. And if President Donald Trump succeeds in replacing the late Justice Ruth Bader Ginsburg with conservative nominee Amy Coney Barrett, the court could be swayed more in favor of overturning Obamacare. That leaves coverage of preexisting conditions up in the air.

During the first presidential debate on September 29, former Vice President and Democratic nominee Joe Biden reminded Americans that the health care of women could really be at stake should the ACA be eliminated. That's because prior to its passage in 2010, pregnancy was considered a preexisting condition—and insurance companies could deny coverage to patients. Before Obamacare, many insurance companies charged women more than men for the same coverage.

It's unclear what, exactly, would change when it comes to health care if Trump wins the election or if the ACA is overturned by the Supreme Court, as Trump has yet to release a detailed health plan. On September 24, the president did release news of the "America First Healthcare Plan," which he says will cover preexisting conditions, but the plan does not go into depth on coverage.

“We’re going to be doing a health care plan very strongly, and protect people with preexisting conditions,” Trump said in a broadcast about the plan, adding, “I have it all ready, and it’s a much better plan for you.” To date, Trump has called Obamacare a "disaster," and Republican repeal-and-replace proposals have not focused on protecting those with preexisting conditions in an effort to lower costs for the healthy. Experts say that though Trump's America First plan claims to cover preexisting conditions, it won't be as comprehensive as what's currently offered under Obamacare.

Trump previously supported the American Health Care Act (AHCA), an ACA replacement bill that House Republicans passed but was stopped by the Senate in 2017, which likely would have meant an increase in health care costs for women.

"Things that are incredibly common for women, including C-sections, pregnancy, and postpartum care, [would have] all [been] considered preexisting conditions," says Kristyn Brandi, OB-GYN at Boston Medical Center, and board member at Physicians for Reproductive Health. "A lot of women [would have ended up] paying out of pocket for health care, which would definitely be a big problem for most women across the country. Women are particularly at risk because they use more health care than other people do. They don’t think of pregnancy as a preexisting condition, so people don’t realize how much they will be impacted."

This is one of the main concerns about overturning the Affordable Care Act, as millions of Americans could lack access to much-needed care. In 2017, the Center for American Progress estimated that people with preexisting conditions could be charged $31,000 in premiums each year under the AHCA plan, while economic analyst Steven Rattner stated that pregnancy would increase premiums by $17,320, depression would increase it by $8,490, and autism would increase it by $5,510. While the AHCA did not pass, Trump's new health care plan does not list many specifics, so it's unclear what exactly would happen to those with preexisting conditions—and whether pregnancy and maternal care costs would increase.

In comparison, Biden plans to build off the existing ACA, giving families more health insurance options. Americans would have the option to go with private insurance or opt for a new public option that would function similar to Medicare. Under Biden's health plan, there would also be a focus on reducing maternal mortality, which disproportionately impacts women of color.

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