Statement of Stacey D. Stewart, President, March of Dimes on implications of individual mandate repeal in tax reform for maternal and child health

November 20, 2017

The March of Dimes released the following statement from President Stacey D. Stewart regarding the Senate’s inclusion of a provision to repeal the Affordable Care Act’s requirement that all individuals demonstrate that they have health insurance or pay a penalty, known as the “individual mandate,” and its expected impact on the health of women of childbearing age, pregnant women, and their children:

The March of Dimes strongly opposes inclusion of repeal of the Affordable Care Act’s individual mandate in the tax reform package being considered by the U.S. Senate and urges its removal from this legislation.  This proposal could have numerous negative consequences for maternal and child health.

“The repeal of the individual mandate could have dire consequences for the estimated 13 million Americans who will become uninsured if it passes. Make no mistake:  Americans will need health care, whether they have insurance coverage or not. Women will get pregnant and be unable to afford prenatal care and delivery services, especially because under the ACA, pregnancy does not trigger a special enrollment period. Any uninsured pregnant woman will be unable to obtain insurance in the individual market until the next open enrollment period, meaning that she could remain uninsured for most or all of her pregnancy.

“Without insurance, many Americans will forego necessary health care. Uninsured women of childbearing age will find it difficult or impossible to obtain regular preventive care, contraception, important screenings, and prenatal care. This proposal makes it more difficult for women to get healthy before they get pregnant and to have healthy babies after they are pregnant.

Repealing the mandate will simply shift health costs from patients and insurance companies onto health care providers and other patients. Rates of uncompensated care will rise again, after dropping markedly in recent years. In many communities, the cost of providing maternity care has already caused hospitals to close their maternity units, and this step could exacerbate that trend. Meanwhile, those individuals who have been responsible and continued to purchase coverage will see their premiums increase by an estimated 10%.  Repealing the individual mandate will not eliminate the need for maternity care, but will change who bears the cost.  

“Finally, the March of Dimes is deeply troubled that the savings estimated to be generated by this proposal are not being used to strengthen our health care system or find innovative ways to offset coverage losses. Instead, they are being used to underwrite tax cuts, few of which are projected benefit the people who will become uninsured. In many cases, the staggering increase in health insurance costs would more than consume any tax relief these individuals receive.

“The March of Dimes urges Congress in the strongest terms to remove the repeal of the individual mandate from its tax reform package.  Repealing the individual mandate without compensatory improvements to our health system is poor public policy, and this tax bill is the wrong vehicle to consider it.” 

Christine Sanchez (571-257-2307)
[email protected]