Your Family: In Sickness and in Health Insurance

Almost half of all births in the USA are funded with medicaid. Fewer than half of all private sector workers have access to paid family and medical leave.

How can I/We… 

What if I find out I’m pregnant — and don’t know how I’ll pay for care? We want to have a baby, but how can we afford it? I have private insurance, but I live in a rural area, will cuts to medicaid affect my local healthcare services? What if I or my baby get sick after my baby is bor, how will I get care? What if my nearest maternity ward closed? What if complications show up weeks later? What if I can’t afford childcare — and can’t afford not to work? What if I need time to care for a newborn—or a sick parent?I’ve been at my job for years, can my boss just replace me if I get sick and need to be out for a while? My mother suffered a fall and needs me to stay with her for a few weeks while she recovers, but I can’t afford to lose my paycheck, what can I do? My husband was injured at his job and needs me to help him get around- how can we make ends meet if we’re both out of work for a few days? What if the tax credit never arrives?

I am pregnant, how will I afford healthcare for me and my baby?

The cost of giving birth in a hospital in the US is more than $18,000. Almost half of all prenatal healthcare in the country is funded by medicaid. (A lot more in some states.) And while the Big Beautiful Bill Act does not directly cut funding for prenatal care, births and post-natal care, cuts to medicaid itself may be so devastating for hospitals that they close, shuttering maternity wards at the same time.

Hundreds of hospitals are at risk of closing due to medicaid cuts.

Fewer than half of all rural hospitals still offer maternity care.

Who will take care of my baby when I am at work?

The average annual cost of childcare is more than $13,000 dollars per year. A large expense for single parents and couples alike. Cuts to important federal programs like Head Start, IDEA and the Preschool Development Program are going to make safe and affordable childcare even harder to find. And, when these programs are cut, the expense of childcare can drive parents out of the workforce, reducing income and increasing reliance on other safety net programs, just to survive.

In much of the US, the monthly cost for childcare is higher than the monthly cost for housing.

Almost half of families with young children spend more than 7% of their income on childcare.

My family member is sick, how can I afford to take time off to take care of them?

The Family and Medical Leave Act is supposed to guarantee job-security for workers who need to take time off to care for a sick loved-one. But, the law does not require that workers be paid while on leave and only 13 states have enacted paid family and medical leave programs. In 2023, only 25% of all private sector workers had access to paid family and medical leave.

The Family and Medical Leave Act helps many workers keep their jobs during a family or medical crisis, but it doesn’t guarantee a paycheck while they’re away from work.

Lots of federal government programs have an impact on our ability to have and raise healthy families and care for our family members throughout all stages of life.  These include:

  • The Centers for Medicare and Medicaid Services. Medicaid and Medicare support families and family formation by providing foundational healthcare for people at all stages of their lives. 41% of all pregnancies, births and post-partum care is currently funded by Medicaid.  
  • The Department of Health and Human Services and The Centers for Disease Control and Prevention (HHS & CDC). HHS and the CDC support healthy families in many ways including setting the childhood vaccine schedules and tracking infectious diseases like influenza and recommending protective vaccines.
  • The Federal Housing Authority (FHA) and the Department of Housing and Urban Development (HUD). The FHA and HUD help American families afford to buy homes and create a stable environment in which to thrive. FHA guarantees mortgages for younger people and people with less credit history. HUD enforces the Fair Housing Act, which prevents lenders and sellers from discrimination against homebuyers and renters.
  • Head Start. Head Start is the federally funded early childhood/pre-k education program for low-income children which is funded through grants administered by HHS. It serves more than 800,000 children, pregnant women and families each year and supports the employment of 250,000 people both directly and through contract services.
  • The Department of Education. In addition to providing funding for public schools in all fifty states, the Department of Education enforces civil rights laws that prevent discrimination in education and guarantees a publicly funded education to all students including those with learning disabilities.
  • The Department of Labor (DOL). DOL enforces the labor laws, including the Family and Medical Leave Act (FMLA), which guarantees private sector employees the right to take time off from work for the birth of a child, an illness, or to care for a sick loved one.
  • Temporary Assistance for Needy Families (TANF). TANF, administered by HHS, is the second largest source of federal funding for childcare.  
  • The Child Tax Credit. The child tax credit, while intended as a benefit to struggling families, is not accessible to very low income earners who don’t owe enough in taxes to qualify for, or qualify for all of, the credit. 

Cuts in some of these programs – most notably Medicaid and medicaid expansion – will harm our ability to access healthcare both during pregnancies and later in life. Meanwhile, policy changes will make it more challenging to do important things for families like buying and keeping a home and holding on to regular and fairly-compensated jobs. Changes at the Department of Education and Head Start will also add to pressure on families.

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