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Is pregnancy a pre existing condition or an excuse to pay more?

Agnus Smith | Published: December 11, 2017

Woman holding pregnant belly

There has been a lot of talks recently in the news about health insurance coverage and pre existing conditions. It can be difficult to know what the current laws are and how they will change in the future. Specifically, there has been a lot of talk about whether or not pregnancy is a pre existing condition. Obtaining affordable health insurance while pregnant can be a tricky situation; let's learn more.

Is Pregnancy a Pre Existing Condition?

At its most basic, a pre existing condition is defined as a health problem that you had before the start of your new health insurance plan. Insurance providers what is and what is not considered pre existing conditions, not the state or federal governments. Many insurance companies consider being pregnant to be a pre existing condition. Before the era of Obamacare, an HMO could charge higher premiums for healthcare to a person with one of these conditions, including a pregnant woman, or deny them coverage entirely. However, according to current law, this is no longer the case.

Will You Need to Pay More If You are Pregnant?

Fortunately, the answer is no. In previous years before the Affordable Care Act was passed, insurers could deny you coverage if you applied while pregnant. This is because they considered pregnancy to be a pre existing condition. However, the ACA made it easier for pregnant women to get the affordable health insurance they needed to receive the best medical care. An HMO is no longer allowed to deny coverage to those with pre existing conditions, no matter if you purchase a group or private plan. Additionally, healthcare companies can no longer charge you more if you are pregnant.

The Future of Health Coverage

Over the past year, there have been a few attempts by the current government to repeal and replace the ACA with a new healthcare bill called the American Health Care Act. This is also known as the AHCA or, more popularly, Trumpcare. As of this moment, the new plan has not yet been enacted into law, though there is a good chance it may be. If the AHCA is passed, it could do away with Obamacare regulations about pre existing conditions. This would give states the right to charge more to those with pre existing conditions, including being pregnant.

As mentioned above, before Obamacare, health insurance providers could deny coverage or charge more for healthcare to those with pre existing conditions. These health problems typically cost more to treat and are, therefore, liabilities to the HMO. Pregnancy is considered to be one of those health conditions, even though it is not a chronic disease or ailment. If Trumpcare is passed, citizens could be facing pre existing conditions regulations similar to those before the ACA.

According to Dr. Leah Kaufman, legislative chair for District II of the American Congress of Obstetricians and Gynecologists, a pregnant woman who chooses to keep her child could end up paying more than $17,000 a year for health insurance coverage under the AHCA. This is more than most women can afford for health insurance each year. Additionally, the bill could also result in an increase in rates for women who have given birth in the past. At the moment, it is unclear whether or not a woman who experiences an expected pregnancy would be forced to pay such high rates.

Under the current law, there is no need to worry about whether or not being pregnant is considered a pre existing condition. However, if the AHCA goes into effect, there may be some cause for alarm. While it is an unknown at the time, health insurance companies may soon consider being pregnant as a pre existing condition, allowing them to charge more to women or flat out deny coverage. The best thing you can do is to prepare for the worst-case scenario.