The Guardian has been running a series called The Mother Load that looks at what happens to pregnant women in the US. Giving birth can be expensive enough even when things go smoothly, but if there are any complications at all, the costs can go so far off the charts that families are ruined. Jen Sinconis writes about what her family went through when her twins were born very prematurely. It is a harrowing tale, not least because while the parents were worrying themselves sick about how to enable their tiny children to survive and grow, they were being socked with massive bills. This was 11 years ago before Obamacare came into being that removed lifetime caps on insurance payments and eliminated pre-exiting conditions clauses that limited coverage. Those two features alone would have made a huge different to them, though they would still have incurred major costs.

Sinconis said that she never dreamed that people in her position would end up like this.

It had never occurred to me the financial repercussions someone could encounter because of an ongoing medical situation. We were a middle-class family with college degrees and solid full-time jobs in marketing and construction management. We owned our house, had very little debt, a savings account, retirement accounts and comprehensive medical insurance. We traveled once or twice per year to exotic locations, we had a rescue dog named Jameson and were enjoying being responsible adults and building our lives together.
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By the time the boys hit 18 months old, we had exceeded the cap on our $2m insurance policy and incurred $450,000 of medical debt. We liquidated our retirement accounts, saving account, sold everything we owned to try and pay it off. When I realized our savings weren’t enough, we listed an estate sale and opened our doors to crowds of Craigslist shoppers telling them “everything is for sale”, and let people wander our house and offer us dollars for the furniture and collectibles we had worked so hard to acquire. I remember someone offering us $300 for our master bed, and I accepted. At this point, who needed a bed to sleep on.

Unfortunately, that didn’t cover it all, and we ended up claiming bankruptcy. We were rejected for prescription refills, and my kids ended up back in the hospital with respiratory illnesses that could have been prevented. At one point my pharmacist told me that if we cancelled our insurance coverage we would qualify for financial assistance, but before the affordable healthcare act was initiated that would have classified them with “pre-existing conditions” and they would never be covered by health insurance again. We had to keep paying the premiums for the insurance that no longer covered anything, while trying to pay for everything out of pocket. All of this while taking care of two very sick, very fragile children.

The Obamacare changes to lifetime caps and pre-existing conditions would have changed our story dramatically. The pre-existing conditions clause forced us to remain in the insurance pool, while the lifetime caps excluded us from coverage. We fell into a gap that very few people hit, but it financially destroyed our family and restricted the care we were able to get for our children.

In the US, as insane as it sounds, medical expenses are the number one cause of bankruptcy.

A recent Harvard University study showed that medical expenses account for approximately 62 percent of personal bankruptcies in the US. Interestingly, the study also showed that 72 percent of those who filed for bankruptcy due to medical expenses had some type of health insurance, thus debunking the myth that only the uninsured face financial catastrophes due to medical-related expenses.

And now Donald Trump and the Republicans want to remove even those basic protections of Obamacare as part of their grand plan to make life hell for the non-wealthy. Life expectancy at birth in the US has declined for the second year in a row and an increasing number of people such as Josh Hoxie are suggesting that it is the US that deserves the label of being a shithole because of the way it treats its most vulnerable people.

Fortunately, far from the halls of 1600 Pennsylvania Avenue, dedicated activists and organizers are working tirelessly to make the U.S. a better place. Social movements like the Women’s March, Black Lives Matter, Indivisible, #MeToo, and a new Poor People’s Campaign are leading the nation in this direction.

Leaders, some whose names we’ll never know, are doing the tireless work to right the wrongs and correct deep-rooted injustices. They know that despite Trump’s slogan, this country has never really been “great” for everyone. They’re the ones working to clean this shithole up.

When I had to have two major surgeries as a child, all that my parents had to worry about was my getting better, and not have to spend a moment’s thought as to how they would pay the bills or the mountain of paperwork that accompanied those bills, the things that parents in the US must contend with. This was because we were living in England at that time and benefitted greatly from that country’s socialized medical system that provided top quality care at one of the premier children’s hospitals (Great Ormond Street Hospital) and was fully funded by everyone’s taxes.

That is how it should be. No one should have to worry about paying for necessary health care for themselves or for their loved ones.