Opinion: Want kids under Trumpcare? It’ll cost you. A lot.

We all know how expensive raising children can be in a country with notoriously limited access to child care (on a personal note, it made me cringe yesterday to look at my pay stub and think how much of it is already accounted for by preschool tuition). But thankfully, my wife and I had children before President Trump ascended to the White House and set about dismantling the health insurance protections put into place by President Obama and Democrats in Congress.

As The Times Deputy Editorial Page Editor Jon Healey writes in an Opinion L.A. blog post this week, new mothers in the future may not be so lucky if the American Health Care Act becomes law. Healey’s advice is for women of child-bearing age to start saving now:

Before the adoption of the Patient Protection and Affordable Care Act in 2010, only 18 states required insurers to include maternity coverage in all policies sold in the “non-group” market. That’s because the requirement is controversial: It raises premiums for those who can’t or won’t get pregnant in order to lower them for those who can.

If Congress lets states opt out of the essential benefits requirement, the CBO predicted, at least some states would do so in an effort to lower premiums for healthier residents. Maternity coverage would be squarely in the targets of states that did not previously require it, simply because it’s so expensive to provide — the average cost is about $17,000 a year, or more than $1,400 a month, for women with private insurance coverage, the CBO said....

The CBO doesn’t expect maternity coverage to simply vanish from employer plans or in states with more limited essential health benefits. Instead, it suggested that the coverage could be sold separately as an add-on policy — but a pricey one.

“Insurers would expect most purchasers to use the benefits and would therefore price that rider at close to the average cost of maternity coverage, which could be more than $1,000 per month,” the CBO wrote in its report. “Alternatively, insurers could offer a lower-cost rider providing less-than-comprehensive coverage — with, for example, a $2,000 limit. Either type of rider would result in substantially higher out-of-pocket health care costs for pregnant women who purchased insurance in the non-group market.”

It’s in everyone’s interests to make childbirth safe and to bring children into the world healthy, just as it’s in everyone’s interests to have good public schools and safe streets. So it makes sense to spread the cost of maternity coverage broadly. The AHCA abandons this principle in its search for an easy way to slow the growth in premiums — for some Americans. On that front, the CBO says, the bill is likely to succeed, causing premiums after 2020 to be lower than they would be if Obamacare were left untouched. But the House GOP’s plan would create real winners and losers, and the latter category clearly includes women of child-bearing age.

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Babies aren’t the only youth adversely affected by Trumpcare. Cal State University and community college students in California will be especially hard hit, given that both systems serve students from predominantly low- to middle-income families that have benefitted the most from the Patient Protection and Affordable Care Act, write Walter Zelman and Tom Epstein. “Even a less onerous version of the act would almost certainly have a substantial negative effect on our students and millions of other Americans,” they warn. L.A. Times

Trumpcare isn’t the only moral outrage to come under scrutiny in Washington this week. The White House’s budget proposal was unveiled Tuesday, and its approach to returning millions of Americans to the labor force is indefensible: It does not address the technological and global forces pushing down the need for workers, but rather it seeks to force Americans back to work by making services such as food stamps and Medicaid harder to obtain. “The crackdown on the neediest and most vulnerable seems even more craven when considering the billions Trump’s budget would shower on defense, border security and tax cuts for high-income Americans, corporations and partnerships,” writes The Times Editorial Board. L.A. Times

California and New York lawmakers want single-payer healthcare. It won’t work. The systems set up in Europe and elsewhere after World War II that are cited glowingly by American liberals were put into place before the invention of expensive new medicines and cutting-edge specialty care, writes Manhattan Institute fellow Chris Pope. Single-payer systems cannot afford to deliver many of the treatments offered in the United States, and patients elsewhere “often don’t know what they’re missing.” National Review

Trump wants to destroy Islamic State. Good. How he wants to defeat the terrorist group that took responsibility for this week’s horrific attack in Manchester, England, however, is problematic, says The Times Editorial Board. He envisions an alliance of Sunni Arab states and the U.S. against Shiite-dominated Iran, the nation that just reelected its moderate president and entered into a positive if imperfect nuclear pact with Western powers. Oh, and Iran also happens to be fighting Islamic State. L.A. Times

Arizona gun laws in Los Angeles? No thanks. LAPD Chief Charlie Beck and Los Angeles City Attorney Mike Feuer warn that two bills in Congress to force all states to honor concealed carry permits issued anywhere in the United States could have dangerous consequences for jurisdictions that have made progress in getting guns off their streets. “Forcing concealed carry reciprocity is dangerous and undermines California’s gun laws,” Beck and Feuer write. “Lawmakers should find the courage to say no.” L.A. Times

Reach me: paul.thornton@latimes.com