A PHS 795 student raises important questions about gender equity and intergenerational effects from potential repealing and replacing of the ACA:
In our past few lectures, we discussed the criteria for assessing health insurance policy as well as the Trump Administration’s impact on health care reform. A brief article from Kaiser Health News suggests that women may incur a disproportionate cost as a result of ACA reform (or dismantlement) because of foreseen policy changes regarding the coverage of maternity care.
According to the article, an estimated 13% of women who purchased health insurance on the individual market (not public insurance or employer-provided insurance) had coverage for maternity care in 2009. The ACA mandated that all plans must cover maternity care, endorsing it as an essential preventive service. With an incoming administration reevaluating what qualifies as preventive care, women who purchase health care in the post-ACA individual market may find few plans that cover maternity care.
We talked about “fairness” as a criterion for health insurance policy, and this piece raises questions on whether these potential changes in coverage are fair to women. I had one question that wasn’t addressed by this article: Is it fair to future children, and should we consider future children in evaluating health policy changes. If we recall Dr. Ehrenthal’s lecture on the life-course trajectory of health, early interventions when a child is in utero can affect birth outcomes and may impact early childhood development. When we evaluate health insurance policy changes, should we consider those affected aside from the single patient? If so, how do we evaluate “secondary” (non-patient) players in policy?
(Note: When I refer to a child in utero, I assume that the mother intends to carry the child to full term.)