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Will a lapse in ACA subsidies imperil Black maternal health?
Will a lapse in ACA subsidies imperil Black maternal health?
Source: Politico
A series of viral videos documenting Black women in active labor going untreated has reignited alarm over the Black maternal mortality crisis. The concerns come as millions brace for an end to Affordable Care Act subsidies, which could significantly raise insurance premiums and further erode access to care for vulnerable communities, particularly pregnant women.
Black women are 2-to-3 times more likely than their white counterparts to die from pregnancy-related causes, according to the Centers for Disease Control and Prevention. A majority of these deaths are preventable, and about two-thirds occur post-partum. Black infants are more than twice as likely to die than their white counterparts.
One of the women captured in the videos was Mercedes Wells. At 38 weeks pregnant, she went into labor with her and her husband Leon’s second child. Wells was calm as she told Leon her contractions were 15 minutes apart and it was time to head to the hospital.
“We did all the right things: We called ahead, let them know she was coming. We were excited about it,” Leon Wells tells Women Rule. But once they got to the hospital, he says, “it still ended badly for us.”
At the hospital, Mercedes Wells’ mother recorded the events that unfolded. The family, according to Wells, was met by a white nurse who refused to acknowledge Wells was in labor — even though Wells told nurses that her water broke and she was in pain. Instead, she was discharged before ever seeing a doctor.
“It was like a nightmare,” Wells tells Women Rule.
As Leon rushed them to a hospital 30 minutes away, Wells gave birth to their baby girl in his pickup truck.
“I was frantic, hoping that we got to the hospital soon, just so that I could finish this process,” Wells says. “The placenta was still inside of me and I’m exposed to this cold air and all these germs in the truck. I just wanted to get to a safe environment for me and the baby.”
As Jocelyn Frye, president of the National Partnership on Women and Families, sees it, the treatment Wells received was “reprehensible.”
“This was not a new story. It is an old story, and it is something that is entirely preventable, and that is even more frustrating,” Frye tells Women Rule.
The push to address Black maternal and infant mortality has stalled since the Biden Administration ended, though a number of Black lawmakers including Reps. Robin Kelly (D-Ill.), Lauren Underwood (D-Ill.) and Alma Adams (D-N.C.) along with Sen. Cory Booker (D-N.J.) have continued to create legislation to address the issue.
These days, Kelly tells Women Rule it’s become even harder to address the ongoing crisis.
“We’ve been working on this for nine to 10 years now, and so we know how important it is, and we also know by what just happened that there’s more work to do,” Kelly says.
Kelly last week announced new legislation, the WELLS Act, named after Mercedes. The Women Expansion for Learning and Labor Safety Act instructs hospitals that provide obstetric, emergency or labor and delivery services to have a “Safe Discharge Labor Plan.” As part of the plan, hospitals must cite a clinical justification for discharging a patient, an identified back-up hospital or birthing facility, verification of reliable transportation and documentation of patient understanding. It would also require racial bias training for health care professionals.
But it’s doubtful the bill will make it far. Democrats have struggled to pass any of their legislation since Republicans gained control of Congress.
Still, Kelly’s legislation comes at a pivotal time: Biden-era tax credits for the Affordable Care Act are set to expire at the end of the month, potentially leading to drastic increases in health insurance costs that some may not be able to afford long term.
For pregnant women especially, Frye says, this could mean losing access to vital prenatal and preventative care. And the birth itself could cost upwards of $20,000 without insurance.
More than 11 million women enrolled in the ACA Marketplace in 2024, according to the National Women’s Law Center. Though the number of Black women enrolled in the ACA is unavailable, studies show the uninsured rate prior to the ACA’s introduction was significantly higher for the demographic.
On the House floor on Monday, Rep. Jennifer McClellan (D-Va.) gave a highly personal accounting of Black maternal risks: she nearly died giving birth to her own daughter. She tells Women Rule she’s worried that a lapse in ACA subsidies will imperil Black maternal health.
“You have families whose premiums are doubling — and in some cases tripling — and they either can’t afford their current plan or have to get a different plan that has a higher deductible,” McClellan says. “If you have to pay more out of pocket, you’re going to do the bare minimum doctor visits that you need to.”
Meanwhile, Wells is currently recovering at home, along with her baby girl. But the postpartum period has been rocky. Both her newborn’s health and her own is “touch and go,” she says, and she has already been rehospitalized for excruciating pain and hemorrhaging.
“This is the time to stand for what we know is right and not back down,” Wells says. “A change has to happen now.”
By Cheyanne M. Daniels