Republican Presidential nominee Donald Trump has made public his plan to reform the health care system in the United States of America. The results, among many other undesirable consequences, include a potential massive spike in the mortality rate of women who are either pregnant or have recently given birth.

A Trump Presidency Could Mean More Deaths for Pregnant Women

The Commonwealth Fund worked up an abstract of the effects of Trump’s healthcare plan, looking at how the plan would affect several areas. The highlights of their findings include:

• The number of uninsured Americans would rise by 9 million individuals
• Coverage losses would disproportionately affect individuals with low incomes and poor health
• Out-of-pocket costs for individuals with coverage would rise by about 50 percent

Right now, these projections of doom and gloom are just hypothetical. Trump hasn’t been elected, and his healthcare plan or some version of it hasn’t been passed into law. There are similar laws already enacted, however, that we have seen the effects of. Among the negative consequences is a dramatic spike in the mortality rate of pregnant women.

The Current Situation in Texas is a Horrifying Omen

In 2011, the state of Texas cut its family planning budget by about 2/3. Since the passage of the Affordable Care Act, Texas has also refused to expand Medicaid. These two policies have left Texas with the highest percentage of uninsured individuals in the United States. Among those are a disproportionate number of African-American and Hispanic women, who account for 59 percent of the live births in the state.

What has been created in Texas is a perfect storm for an increase in the maternal death rate. The exact women who are most likely to be uninsured are the same women who are most likely to get pregnant. On top of that, there is a sharp decrease in the places where any women can go to acquire abortions, birth control, prenatal care, and post-natal care. The result is that maternal mortality in Texas elevated by nearly 200% from 2010 to 2014 according to the medical journal Obstetrics and Gynecology.

To make the situation even more harrowing for minority women in the state, African-American and Hispanic women have accounted for 60 percent of those deaths. With no significant momentum in the state legislature to expand Medicaid or restore family planning spending, it’s difficult to see how the situation for women in Texas can improve anytime soon.

How the Rest of the US Could Become Texas

While there are differences between Texas and other states that must be acknowledged, such as population demographics and income distribution, it’s not difficult to see how similar policies being enacted on a national level could have similar effects all over the United States.

There are two major ways that Trump’s plan could quickly create a scenario all across the country that mimics the current status quo in Texas:

The repeal of the Affordable Care Act and all of its provisions would wipe out the federal subsidies currently given to low- and middle-income individuals who, prior to the law’s passage, were not eligible for Medicaid. The program also does nothing to replace those subsidies. The only potential benefit to the individual in Trump’s program is a new income tax deduction for health insurance premiums. That does nothing to help anyone who can’t afford coverage in the first place, again, disproportionately affecting minority women.

Trump’s plan could reverse the momentum gained through the Affordable Care Act toward putting medical professionals–not insurance companies–in the driver’s seat of health care decisions. Currently, insurance companies are legally barred from denying coverage to individuals with preexisting conditions and charging higher premiums or imposing lower policy maximums based on an individual’s risk factors.

Under Trump’s plan, those legal restrictions would be removed. Insurance companies would be free to charge higher premiums to minority women under Trump’s policy. It’s likely that they would do so because of the higher pregnancy rates, among other factors. That would only act to increase the likelihood that such women would go through pregnancy without necessary medical attention, either because of an inability to access the care or an inability to pay for the care.

By removing the legal obstacles and financial assistance that is keeping the maternal mortality rate from skyrocketing elsewhere in the country, Trump’s plan could spread the tragic situation facing women in Texas to the rest of the country should he be elected.

It’s possible that a United States Senate controlled by the Democratic Party could block the repeal of the Affordable Care Act and the passage of Trump’s plan, but the Democrats taking control of the Senate is yet to be decided. The most concrete hope to avoid the potentially tragic results that we have already seen in Texas is for citizens to realize what has created the situation and use the power of the vote to keep officials who seek to enact those policies on a national level out of office.

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