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How Being A Woman Will Become More Expensive Under Trump


Raise your hand if you’re still freaked out about the next President of the United States. As a self-employed, half Latina woman, I imagine I’ll be freaking out for most of the next four years.

Trump represents a threat to almost every part of my life. He’s made insane and harmful remarks about different groups that I identify with, and he plans on demolishing social plans that are key to me being able to live the life I live. Right now, the biggest concern I have is what Trump will do to my healthcare. I’ve been on a plan from the ACA for the last two years. As a very low-income woman who receives no parental or spousal support, the ACA is critical to my ability to take care of myself.

In 2015, I paid $67 a month for a Silver rank healthcare plan. I got a substantial tax credit, because in 2014 I only earned $15,000. This year, I’ve paid $167 a month for healthcare, because last year I earned $33,000.

$167 is steep for my tiny budget, but it’s much better than what health care would cost under Trump. Health Care costs can be especially high for women, who often bear the burden of additional costs like birth control and pap smears.

I want to specifically address reproductive health costs. After it was declared that Trump was elected, I spent a day calling around trying to find a doctor that took my insurance, wasn’t Catholic, and had an opening for me to come in and get an IUD. Trump is no hero of women’s health choices. This is the man who literally said women should be punished for getting abortions, a legal and sometimes medically-necessary procedure.

Under the ACA, birth control and medically-necessary procedures like pap smears are free. They are considered preventative health measures, and therefore should be covered by your insurance payment. Before the ACA, women paid nearly $1 billion more than men in healthcare costs, largely due to being charged for maternity care costs. Since the ACA passed, women have had free access to all FDA-approved contraceptives,  well-woman visits at least once a year, screening for gestational diabetes, counseling and screening for sexually transmitted infections, breastfeeding support, counseling and supplies, and screening and counseling for domestic violence. Under Trump, these services could go away, or come with a high price tag.

After calling six different clinics and spending several hours on the phone with nurses, I found a clinic that would give me an IUD. I went to two appointments there, ended up getting the Nexplanon insertion, and didn’t pay a single dime.

It’s still not clear exactly what Trump’s healthcare plan is, especially as he’s flip-flopped on his feelings on the ACA. However, his own website sets out a list of action items regarding healthcare, and number one is repealing the ACA. The rest of his list includes incredibly vague language like this: “By following free market principles and working together to create sound public policy that will broaden healthcare access, make healthcare more affordable and improve the quality of the care available to all Americans.”

Trump recently picked Tom Price as his Health and Human Services Secretary. Price has been at the forefront of the movement to repeal the ACA. He is also the chairman of the House Budget Committee, and introduced a bill that would repeal and replace the ACA. His plan features tax credits linked to age rather than income, meaning older Americans would catch a break, and younger Americans would not. People with pre-existing conditions would face an uphill battle, getting covered under his plan only if they’ve been continuously covered in the past. He also supports block grants to states for Medicaid costs.

For someone like me, repeal of the ACA is the worst case scenario. The ACA is far from perfect, but it’s easy to use, offers a variety of plans, and doesn’t charge me more for being born with a vagina.

While we don’t exactly know what Trump is going to do to healthcare, it’s a pretty safe bet that fewer people will be covered as thoroughly as they have been under the ACA. If the mandate in the ACA that requires all Americans to have health insurance goes away, health care costs will skyrocket even more than they have in the past. We’re looking at a more expensive future, especially if you’re a woman.

I would bet every dollar I have that I won’t be able to get a free-long term birth control in less than a week under a Trump presidency. I am angry and scared that our president-elect doesn’t take women’s health seriously. Worse, he might even consider women’s health merely an opportunity to make money.

We already know Trump doesn’t respect women. It doesn’t lead to much hope for what he will do to women’s healthcare. If you want to get involved, stay tuned politically to what happens with healthcare in Congress. Call or write a letter to your representatives that says you support the ACA. Support organizations like the National Women’s Law Center or Planned Parenthood, which help keep women safe and healthy.

Kara Perez is the founder of bravely, a new company that connects women and money. She lives to talk money, and for peanut butter straight out of the jar. You can find bravely on Twitter and Instagram.

Image via Pexels


  • nicolacash

    More expensive under Trump for those who have health insurance under the ACA…I’m pretty sure the costs for people who get their health insurance from their employer will remain the same

    • Kara

      Possibly, though a lot of the power for healthcare looks like it’ll be delegated to states. So it can really depend on where in the US you live, and whether or not your employer decides to cover things like birth control. Prices could still spike for private insurers, though that is only a possibility at this point.

    • GBee

      ACA mandates all individual and group health plans fully cover preventive services – meaning you cannot be charged a copay, coinsurance or deductible for any of those services. Prior to ACA I would have had a copay for my doctor visits that are now “free” = paid for through my insurance premium. Also, birth control costs would increase.

    • Court E. Thompson

      Yes, but we’ll lose the birth control and preventative care coverage. Those were both mandates for all insurance coverage that happened through ACA. Also it includes coverage for those with pre-existing conditions and eliminated lifetime caps – those are particularly necessary for anyone with serious diseases/cancers/etc. ACA also mandated the 80/20 rule, where 80% of premiums had to go to actual healthcare coverage, not admin costs.

      ACA was not just providing government subsidized healthcare to those who couldn’t afford private and didn’t qualify for Medicaid. It affected private insurance that everyone received through their employers as well.

  • While this site has made its political leaning clear, I think the way it’s discussed could be adjusted. For example, this article is actually focused on “How being a woman will be more expensive under the repeal of the affordable care act.” As the commenter below said, it’s generally focused on those who have health insurance through the ACA. I know that for me, access to birth control wouldn’t go away, but it would cost me the copay instead of being free to me.

    I also wish this article had shown more of the hard numbers related to it. For example, what is the cost of going to a gynecologist annually. What is the cost/likelihood of a woman having a female related illness (cervical cancer) versus a male equivalent (prostate cancer)?

    I understand the point of view, but wish it had been looked at more specifically and thoroughly.

    • Kara

      Hey Emily,
      I understand your feelings, but as Trump has made repealing the ACA the cornerstone of both his campaign and his to do list for the first 100 days, I felt it was ok to say that this is how it’ll get more expensive under him. Under HRC, this wouldn’t be the same issue.
      It’s difficult to share hard numbers when it comes to healthcare because they can de so different. Depending on your type of cancer, type of healthcare, and income, your costs vary wildly. That’s frustrating, but true.
      The cost of a pap smear can vary from $50-$200 without insurance. With such wide ranges, I decided to forgo giving specifics. You can look into your own coverage to find out what the costs might be.

  • TreeTownGirl

    As a woman diagnosed with ovarian cancer at 26– the wholesale repeal of the ACA is horrifying possibility– something about reading this stirred something in me. My diagnosis opened me up to a world of young adult cancer survivors, not to mention young adults with chronic conditions and I feel for everyone one of us right now facing Trump’s presidency. My cancer was considered sporadic– totally random– nothing about my lifestyle caused it and I tested negative for every likely genetic abnormality. The thought of lifetime caps returning is truly, truly a nightmare after watching the insurance statements pour in, totaling in the hundreds of thousands of dollars. I’m seriously considering an IUD now (as I did not undergo a hysterectomy) because I’m not sure if I want to have children having had cancer at such a young age myself.

    I don’t think any young adult, already trying to figure out how to live out their 20’s and 30’s with their respective health conditions, should now also have to consider that their insurance might run out later in life. Potentially not even much later in their life, through not fault of their own. I don’t think any of us should have to face steeper out of pocket costs for something as “benign” or “optional” as birth control that carries great emotional significance in addition to medical significance.

    • Kara

      Thanks so much for writing in! I’m so glad you were able to get the treatment you needed, and I hope you’re ok now. I agree with you that lifetime caps are terrifying. They totally abandon those who get sick young, or often, and they offer no other solution. I would recommend an IUD if your body is up to it!

  • T

    Just want to clarify – your birth control was never “free” – You may think it’s free if you don’t have a copay for it, but it was either paid by you through your health insurance premium, or partly subsidized by the US tax payer on an ACA plan. Someone out there is paying for it.

    • Kara

      This is a fairly asinine comment, but here you go: I didn’t have to pay a copay, so my out of pocket costs were $0. As a taxpayer, I help to subsidize the ACA, the same way that millions of other Americans do. We all share the burden so that no one has to shoulder it alone.

    • sara

      I totally agree that someone is paying for it! Last year, I had a gap in employment and ACA approved insurance was going to be $800/month for me (and just me!). My husband and I combined last year made about $70K, which is comfortable where we live, but who can afford $800/month for health insurance? I skipped it and bought catastrophe insurance instead.

      I get that a lot of people are on birth control pills, but there are other (cheaper) options like condoms that don’t require a doctor’s visit.

      • Condoms fail a lot more than hormonal birth control does. And hormonal birth control is far, far cheaper than paying for an unintended pregnancy, and 18 years of care for the resulting child.

      • Court E. Thompson

        But condoms don’t help with irregular periods, severe cramps, or all of the other reasons that women use birth control that has nothing to do with sex. I used it for a month to control bleeding from a LEEP procedure that left me weak and anemic. It’s not just about having sex. It’s an integral part of many women’s health and wellness.

  • ATL

    I do believe that women should have access to the healthcare that she deems best for her body. However, having sex as a single woman does come with some possible consequences of incurring higher expenses due to preventative measures regarding screenings and contraceptives. With any choice a person makes, it is the responsibility of that person to handle any repurcussions. A woman has the right to decide her level of sexual activity and the financial responsibility of her choices belongs to her and not taxpayers.

    • Valérie Rodrigue

      And how is it fair that women who have sex should bear the cost of birth control when men do not?
      Also, this argument completely disregards the positive externalities related to accessible health care (lower rates of diseases, teen pregnancies, abusive relationships, etc.). Taxpayers reap benefits from those externalities, it is thus normal that some of their tax money is going towards social programs.

      • ATL

        Men can buy condoms. Many married men have vasectomies. I do believe there are positive aspects to reproductive healthcare and I was absolutely speaking in terms of consensual sexual relationships. My main point was that if it is one’s choice, it is one’s own financial responsibility.

    • nancxpants

      And what about the people who are prescribed hormonal birth control for other reasons? I had surgery to remove an ovarian tumor as well as several cysts when I was 12 years old, and because of that my doctor began recommending the pill to me (before I was sexually active) to help prevent future cyst growth. I have friends who had debilitating PMS pains that would keep them from their normal activities, and the pill has helped reign that in. Please remind me of the choices we made for which we should have to shoulder the financial “repercussions”.

      • ATL

        Hi! I’m referring specifically to healthcare that is a result of sexual activity. Obviously your condition or others similar are not a result of choices and are not at all what I was referring to.

        • nancxpants

          Except that it was exactly what you’re referring to. What you said in your original comment is that taxpayers shouldn’t have to pay for medical expenses that result from a person’s choice, but my point is that it’s not always so cut and dry. From the pharmacy’s perspective, and an insurance company’s, my birth control pills and those of a woman who gets it “just” because she’s sexually active are the same.

          • ATL

            Check with your insurance. If you have a certain diagnosis, you should be able to get a waiver from your doctor for your plan to cover birth control for your specific medical condition.

          • nancxpants

            I suppose I would just rather ensure that health insurance companies do what their supposed to and cover the prescribed medications of individuals with their plans. Well actually, I’d rather we stop stigmatizing the choice made by consenting adults to be sexually active, but hey.

            You’ve brought up vasectomies in other comments — should they be covered by insurance? No one pushes to reclassify their coverage. If you don’t want to pay for women’s preventative measures, why is paying for a man’s ok?

          • ATL

            I think you have misunderstood what I was saying. Of course all these should be covered by insurance. My personal belief is that we are all responsible for covering our own health expenses, be that by self-pay or insurance premiums. Holding someone financially responsible is in no way stigmatizing. We are all responsible for our own choices and the results of them.

        • 1) What about having sex as a non-single woman? Do wives, or otherwise partnered women, magically get access to taxpayer-supported birth control?

          2) How do you feel about taxpayer-supported healthcare for pregnant women? Or hell, children?? They’re (typically) a result of choices about sexual activity too.

          3) What about care for people suffering from lung cancer due to smoking? For those who are overweight? Someone who got in a car crash while they weren’t wearing their seatbelt? Are coal miners suffering from lung-related diseases responsible for paying for their own care, because they chose that field of work?

          Where do the personal choices that make other people responsible for their healthcare costs end, and the decision that it’s better for people to be healthy, contributing members of society than giving back a few dollars to the lucky handful who don’t currently have any medical conditions begin? Or is it just sexual activity that should be policed?

          • ATL

            Hey Calamity! I like how you numbered your questions so I’ll do the same.

            1) Having sex in a monogamous relationship with a partner who is clean of STD’s cuts the need and/or costs of preventative reproductive healthcare. For example, research shows that pap smears are needed to detect cervical cancer. Well, if you don’t have HPV and are not at risk for contracting it (ie in a monogamous relationship) then you can’t get cervical cancer so screening for it is not necessary. Also, married or partnered women often have the privilege of having the income of their partner/spouse to supplement the costs of reproductive healthcare. And also, a man can get a vasectomy so that birth control is no longer needed. It’s also a lot more manageable financially to have a child while in a partnered relationship.

            2) Exactly. The lesser of two evils (not that it’s evil but you know) is for taxpayers to pay for a woman’s birth control which is a lot less expensive than paying for the cost of a pregnancy or raising a child. However, I stand by my original statement from the very beginning. If you cannot afford the consequences of your choices, don’t make that choice.

            3) Yeah, if someone is making any choice that is going to jeopardize their health and they still willingly make that choice, then it is that person’s responsibility to cover any additional costs resulting from that choice. I’m not sure about the coal miner’s thing, but I’m thinking they might have a lawsuit option.

    • Court E. Thompson

      You’re right, a woman does have the right to choose her level of sexual activity. Where do the taxpayers come in? If you go for a pap smear, that is covered. Pap smears are recommended every two years whether you’re sexually active or not because it looks at the entire health of your reproductive system. If you need additional testing after that, it’s not covered. Birth control is a medication that, if prescribed by a doctor, can be covered fully by insurance. Not by taxpayers.

      I’m not sure what your issue is.

  • Mj D’Arco

    the aca made it cheaper to be a woman, and more expensive to be a human being.. how many families saw their premiums and deductibles go up?