How do poor people in the states give birth without money?

My sister was on welfare and had a kid around the same time as me. Hers was covered completely by Medicaid.
Mine, because I had a job and health insurance, cost me $20,000. Didn’t finish paying for the kid until her 2nd birthday.
- Oh my.
  
  Medicaid is the correct answer. Surprised more people aren't mentioning it. It's specifically in place to cover people with low incomes who often don't have insurance through an employer.
  Medicaid will often cover the cost of child birth for low-income people 100%.
  That being said, if you have slightly higher income than allowed to enroll in Medicaid, your only option may be a long-term payment plan and lots of debt that you may carry for the rest of your life. It's an awful system that really only benefits the strong.
  Canada, don't go down that road.
- That's pretty much how it works. Newborns qualify for Medicaid, and low income pregnant women generally do too.
- I always wonder what would of happened to my son if I wasn't Canadian. He was not growing properly in the womb which meant many doctors appointments and ultrasounds . And then he was born 3 months premature and spent 3 months in the NICU. I didn't have to pay a cent for any of it .
  
  Natural selection would have taken place if you were American
- Are you familiar enough with the details to share them? Because this sounds strange to me - every plan has an out of pocket maximum and the highest I've seen is $14k. Are you including premiums? Do the costs span multiple years?
  
  This was pre-Obamacare, and the birth alone - with c section - was $20k.
  
  I'm not American so maybe I'm getting something wrong... But aren't you making a faulty assumption about people having a plan at all? Isn't the amount of completely uninsured in the us in the double digits or something?

Have I personally avoided going to the hospital? Absofuckinglutely. Unless I’m in immediate danger of dying I’ll figure it out myself. I’ve superglued more than one nasty cut that probably needed stitches, entirely possible I’ve ignored more than one concussion. Is it smart? Unequivocally and resoundingly not. Do I do it anyway so I can pay my rent? Yep.
- I wonder about the effects of having a low grade constant stressor like that. Combine that with at-will employment and gum prevalence and it’s surprising anyone is able to feel secure and get healthy.
  
  Purely anecdotal, since I can only draw from my own personal pool, but I don’t have a single friend or colleague who feels even remotely secure in their life. We’re all one emergency away from bankruptcy.
  
  The effects of having low grade stressor like that, combined with non-federal sick leave nor vacation and predatory corporate labor laws are what you witness in the US every day. Precipitously declining mental health for everyone, reduced social and coping skills. Commonplace violence and rage and incredible rates of anxiety and depression and resultant medication.
  
  I wonder about the effects of having a low grade constant stressor like that.
  Heart disease like irregular heartbeat and stroke. Gastrointestinal problems such as ulcers and IBS. Increased susceptibility to illness. Ability to learn/memorize/perceive are reduced. Not to mention the effects of maladaptive coping mechanisms such as drinking, smoking, drugs etc.
  Source.
  Many disorders originate from stress, especially if the stress is severe and prolonged. The medical community needs to have a greater appreciation for the significant role that stress may play in various diseases and then treat the patient accordingly using both pharmacological (medications and/or nutraceuticals) and non-pharmacological (change in lifestyle, daily exercise, healthy nutrition, and stress reduction programs) therapeutic interventions.
  
  I whole heartedly agree... We should ban all gum... Big chew included 😋/s
- I make good money and have reasonable health insurance. However, I grew up super poor. So I only use health insurance in life or death circumstances.
  I don't want to be poor again.
- Definitely same.
  For our northern cousins, an illustrative story. I was attacked by a dog and with my arm and leg bleeding everywhere my first call was to my wife to get her to come pick me up because I knew an ambulance would be insanely expensive, and my second call was to insurance to find out if I could go to the hospital instead of urgent care. They sent me to urgent care, where they told me it was the worst attack they'd ever seen that wasn't on the face.
  The kicker is that I even have GOOD insurance, but that's the reality of not knowing if it's gonna bankrupt you or be covered or not: hesitation. That's the reality of having years of habit-forming second-guessing when you had bad insurance, or when with good insurance and a tight budget. Imagine what is like for people with bad or no insurance.
- Are you sure you don’t qualify for Medicaid or other public assistance?
  
  Yep. I make ok money and have insurance. Things being what they are, rent has skyrocketed over the past couple years. Food seems to be coming down in price but for a while there it was pretty alarming. I haven’t had a significant raise in about 3 years to keep up with cost of living increases. Choices must be made and if life and limb aren’t in immediate danger, I choose to not have a bill of several thousand dollars for something like a few stitches and/or fight with my insurance company over coverage.
- My housemate lost his awesome mom when he was like, 10, because of that. She refused to go to the hospital because she couldn't afford it, and it got infected. Fuck this country.
- This doesn't answer OPs questions at all. Medicaid is available for expecting families that covers the cost of prenatal, birthing, and postnatal services.

I can answer this: my son was born in 1990. We were extremely poor.
We had midwives help us out as best they could, to the tune of about $3200 at the time. The birth got complicated due to a variety of health factors, and both my son and wife almost died (not because of the midwives). Luckily the midwives had a direct line to Georgetown Hospital, and the cesarean was done there. The total hospital bill was $58,000, or $138k in today's money, although hospital costs have rose much higher vs inflation, so maybe it would be in the $200k range now. She was in the ICU for a week, hospital for another week, our son for about 3 weeks.
My wife job didn't have health insurance, because it wasn't required back then. Because she was gone a week, her job fired her for an unexcused absence. Oddly enough, this made her unemployed and Washington DC had some law (or rule or something) that immediately dropped the hospital bills because of her unemployment. In the end, we had to pay $15k to about two dozen practices who individually sued us, which took 7 years to pay off and a lot of court visits and wage garnishments. It financially ruined us, pretty much. Both suffered a lot afterwards because we just couldn't afford minimal care. It was hellish. I can't imagine how much worse it would be today. We got evicted from our apartment, and lived in government housing for six years.
So, yeah. Don't have a baby in America unless you can guarantee it will be healthy and you have a lot of money. Most of my friends don't have kids, they simply can't afford it and look at it like the previous generation looked at concepts like summer homes and yachts. Nice luxuries, but way out of affordabilty.
- Wow. That's horrible. The US health system sounds like a dystopian nightmare.
  
  And yet so many Canadians seem to want to dive head first in to a fully private healthcare system as if anyone could take that financial hit.
- I'm sorry you and your family had to go through that.
  I'm Canadian and I gladly pay more taxes than you so that I and my friends get free healthcare when we need it.
  When we watched the fights over "Obamacare" we just shook our heads.
  
  That's the ridiculous thing. Americans would rather pay a few dollars less in taxes than let people have free healthcare. And it ends up costing them far more than they would have paid in taxes.
  
  I'm Canadian and I gladly pay more taxes than you so that I and my friends get free healthcare when we need it.
  Here's the thing. I worked in America for the better part of a decade and I had to submit two tax forms, one to each country. You end up paying the greater of the two and using it to offset the other.
  What I know is this: every year, every year, I paid an extra 1% to America. No matter how my (binational) tax guys worked it, my obligation to America was always higher.
  The year after I came home I still had to submit taxes (January layoff scares so I moved back) and it was still higher for America despite sitting in a different country (it's a factor) and using different services. It didn't matter.
  In Canada I pay 1% lower income tax and enjoy healthcare access. While they've done away with the regional premiums, I was even okay paying that; as my yearly outlay, proudly at the top bracket, was still less than copays while in America. I would gladly pay the same premium to ensure equal access to dental and optical care for me and especially people who can't drop (now) c$1000 on some specs or way more on a dental crown.
  It's not that I'm a good guy, but I pay taxes for schools because I don't want to live around dumb people. I do and will pay taxes so we can take people who aren't healthy and skilled and contributing income tax and make them so they are. Poverty should be no excuse for not being employable.
- What the actual fuck, and this was in 1990
  
  1990 was around the time of Hillary-care and Romney-care, so the politicians knew that they were going to have to fix it sooner or later by that point.
- Man.... That is crazy. I'm so sorry for you guys.
- Why didn't you have taxpayer paid (State) insurance if you were extremely poor and expecting? Is it because of the lost job and timing? If you are poor and have a family then you can spend a day at the welfare office and get public insurance.
  
  Because we made too much (over minimum wage, dual income household). I was making $13k as a sales manager, my wife was making $8k as an assistant manager, and minimum wage was $3.35/hr or just under $7k/year back then. After taxes, we made about $1200/mo, and our rent was $650 for a single bedroom apartment. No car, we took the bus, barely had enough for food and utilities.
  But we were considered way too over the "poverty line," which was I think less than $6k/year then. We had been using birth control but when they say some form of birth control is 99% effective, the DO mean 1% failed. I have no regrets our son was born, because it turned out we couldn't have kids later when we tried. And then later my wife died when he was 22, so if we had kids later, I would have been a widow with younger kids.
  I feel awful he grew up poor with us until he was about 10, though.
- ... "So, yeah. Don’t have a baby in America..."
  for more on this subject, and in the spirit of looking on the bright side of s bad situation, see /c/childfree and childfree.cc. Includes talk, and memes, about some of the benefits, of not having children, including but not limited to finances. (also advice and directories about related options for medical things, where thise are wanted or needed).

Ah... In short.. Insurance covers a portion of it and whatever insurance doesn't pay, I just... Simply don't pay it. It goes to collections and they spam call me and I don't answer my phone. Suddenly they give up and after 7 years, it's gone. Is it right? I don't know. I definitely haven't devoted half of my paycheck to medical bills though.
- Does that bork your credit?
  
  Yes it does
- Once I got some physical therapy bills sent to collections. It wasn’t because I failed to pay. The practice was really shitty about billing and record keeping and never billed me for a bunch of visits. They went under and sent their records over to collections.
  The collectors called me and pretty much opened with “this place went out of business. We would settle for pretty much anything. How about 10% of what you owe?”
  They get a percentage of everything they collect so you might think they’d go for the full amount. But I think the game is sometimes just “what can we get easily and quickly.”

Do people ever avoid hospital visits
At least in my experience, we’ll generally be able to go to the hospital
Do hospitals put people on a payment plan
Generally, I’ve just seen the debt transferred to a debt collection agency afterwards, since there’s no money for them to take. They’ll harass you, and it affects your credit score, but they can’t send you to jail
- Credit score? Is it like the Chinese social credit system?
  
  Yeah, just the American version
  It affects where you can rent housing, what houses you can buy, whether you can get a car, etc
  
  The US version is a system that calculates the risk of loaning money vs being paid back. In order to be approved for a loan the credit score is used to evaluate whether or not it is likely to be paid back within the terms of the loan. As a result those with bad credit have trouble getting favorable terms for cars, housing and basically anything that can't be purchased outright. Does it negatively affect people for things outside of their control and perpetuate cycles of poverty? Absolutely, but it is based in actual fiscal risk to calculate sustainable loan practices.
  China on the other hand took the US term of "credit" and abused the everloving shit out of it to punish people that the government dislikes. Did your cousin post a Xi Jinping Winnie the Pooh meme? Well too bad that you were shopping for a house, because your "credit" is no longer high enough to not be homeless. You should have thought of that before you were related to someone who disagreed with the government!
  Not being able to demonstrate to a bank that you are financially reliable enough to pay back a loan is unfortunate, but a rational reason for an unfavorable interest rate or denial of a loan. Making people ineligible for even renting an apartment that is within their financial means because the dictator in charge dislikes you is a completely different thing altogether.
  
  It’s similar but only take into account financial and professional information. As I understand it, the Chinese version also covers your daily activities.
  
  Not really. It just keeps track of how often you miss your credit card payments so creditors will know how high of a risk you are to lend money to. If affects if you can get loans and what interest rates you can get on loans. But if you just pay your loans/credit card bills, you'll be fine.
  
  As the name hints, a credit score is used to rate the risk of making you a loan. It’s not some essential personal ID. It only comes into play if you are applying for credit and is a set of shared records that financial institutions and private companies use to decide if loaning you money is a good risk or not.
  Someone else said it’s used to decide if you can get a car and that’s not accurate. If you need to borrow money to buy a car, your credit history will be checked. It’s the loan, not the car.
  Is it crazy that lenders would want to know if you’ve walked away from your bills in the past? Making it sound like dystopian China is a gross exaggeration.
  Landlords want to know if you will be able to pay rent and they may ask to know what you earn, what’s in your bank account, and if you have insane debt. It’s not credit per se but they are entering into a financial agreement with you which you could default on, so it’s got many of the same characteristics. Don’t want to give all this information? Don’t. It’s not required by law. Not everyone demands it. Some may choose not to rent to you without it.
  
  At this point, pretty much
  
  yes, but in the classically American fashion we only care about money so much only the money stuff even goes into calculating it
- Would a hospital ever refuse you care if you have outstanding bills or hospital bills with collections?
  
  It’s illegal in the Emergency Room. Anywhere else they can. Poor people end up relying on Emergency care, ignoring bills, and the hospitals write it off as “charity care,” which helps them justify their non-profit status, when they’re non-profits
  
  Depends on the severity of the issue.
  For a life threatening emergency, no
  For like pain relief, yes
  
  The hospital must stabilize you and save your life from immediate danger. They don't have to make you better or solve the problem.

Simply.
They don’t pay the hospital bills.
- Wait for them to repo the baby...
- "they don't pay"
  Yikes, real "us vs them" without any experience understanding or compassion, eh?
  
  I understand the point you are trying to make, but I'm not sure what you are reading into? The question was "how do poor people in the states..." I am a poor person in the states, if I was to answer I would probably say they, maybe 'we' if I was feeling like sharing. And it's true, many medical bills throughout my childhood that we couldn't afford just went unpaid, with debt on my parents credit.
  
  Wow u just made up all that in ur head...just ...wow.
  
  This is unfortunately true, though. A lot of people just don't pay them, especially homeless people. How are they gonna get billed? They have no address and many don't even have a phone. I'm not making a moral judgement, but it does happen very often.
  Source: husband is an ER doc at a city hospital that serves most of the city's homeless and below-poverty-line population where we live.
  
  Downvotes without any replies? Yeah, that checks out.

If you are poor enough you can qualify for Medicaid (MediCal in California) which is a sort of limited health insurance. This is life saving for poorer families and most of the time completely covers birth costs. After birth in some states they even offer follow up plans from nurses for assistance with food and meal plans for babies and toddlers.
Even if you don't qualify you can apply for financial aid which I believe is required to be offered in every public hospital even to people whether citizens or not. If not you can just take on the debt and not pay, which destroys your credit score but after long enough you might be offered a favorable financing or a discount... Only after being harassed by collections for months if not years.
Source: not American but I've worked with American healthcare workers interpreting for Spanish.
- Also to clarify saying if you're poor enough makes it seem like it's a high bar, but iirc ~35% of people are on Medicare/Medicaid
- Came here to explain this.
- I just explained this before seeing your post. There's a lot of America bashing in this thread with completely inaccurate information. I was relatively poor when my son was born and we were on public insurance. Everything was paid for. It was actually a pretty good overall experience. Now that I'm making a lot more money I don't complain at all about taxes, since I know that at least some of it goes towards invaluable services like this.

They send the infant to debtors prison to begin working off the $70,000 hospital bill. They don't have to pay the infant minimum wage though, and they charge them for room and board and meals, so by the time they're 18 they are actually indebted to the hospital an average of 1.4 million dollars, which they will then begin working off as adults earning minimum wage.
- I man you joke, but don’t give them any ideas.
- Arkansas has upvoted your comment and taken notes.
  
  Ohio awaits program completion and results to “improve” on it.
- I know you're joking, but Im pretty sure that there was a supreme court case that made debtors prison a thing of the past.
  
  deleted by creator

American hospitals cannot legally refuse to treat you even if they know you can't pay/don't have insurance. So worst case scenario is you go and have whatever done and they bill you and you don't pay and it's a write off for the hospital.
Often times, if you can't pay they will offer a reduced amount to at least get something out of you if they know they won't get anything otherwise.
- Fucking crooks
  Edit: who the fuck is downvoting me? USA hosptials owners?
  
  People are thinking you mean the poor people, not the hospitals.
  
  It's very expensive to be poor.

Was poor, had a baby at 20. $6,000 hospital bill we paid in monthly installments of like $100
Paid off my kid being born when she was like 6 or 7 lol. Kind of like a car

- If you have a masters and 20 years of experience, you're pretty much guaranteed to have a job that has the health insurance to pay for all of that. If you don't, then you need a new job
  
  If they've got a masters and 20 years of experience they're either a genius or almost 50 years old. Children are already a huge commitment, being older makes it that much harder
  
  Health insurance still leaves you with a large bill. Expect like $10k for the hospital part for a lot of insurances. Don't forget the obgyn visits throughout the pregnancy (probably only $25-$75 per visit, depending on if you need a specialist). Labs are extra. In fact, the one that really tells a lot of info (lots of recessive gene issues can be found with it) is like a $750 lab that insurance doesn't usually pay for ("it's too new, and not required").
  
  Sure, maybe the hospital bills but raising 3 kids and going on vacations every year? You’re talking multi million dollar salary to be able to afford all of that on one income in SoCal of all places
- Leave California and this all becomes possible with your salary.
  
  When he leaves California, he will leave his salary too (and possibly his industry too)
- I live in SoCal and love it, and do not intend to have kids, but it really seems like you'd be struggling to raise 3 kids around here on less than $150k (2 cars, rent/mortgage, etc).
  Obviously many people manage it somehow, but it must be incredibly stressful. I have no idea how most of them do it.

Vaginally

Some people give birth in their own homes like in medival times. I know people who have done it. In my opinion people shouldn't be having kids if society is so broken you have to do stuff like this but to each their own.
- There's nothing wrong with it. Thats what midwives are for.
  
  Until it goes wrong.
- We opted to have our second at home in a birthing pool, it was amazing! Mum and baby were monitored way more than when we were in the hospital with our first, and we could just recover and relax in our own home after. No stressing about having to get to the hospital etc.

Mine were born at home with a midwife who did sliding scale pricing (charged based on your income). Only available to low risk women who lived close to the hospital though.
If you are quite poor, Medicaid will cover pregnancy and hospital birth expenses, even if you don't otherwise qualify. I know someone who did that and said the nurse yelled at her because she wasn't married.

Debt. Massive amounts of debt.

As a poor Florida resident who grew up and has known several people giving birth in poverty; if you're lucky you qualify for WIC (women, infants, and children) which is essentially food stamps/ welfare for pregnant women and mothers. That covers food. If you qualify for WIC then you're also eligible for Medicaid which is the US' version of free* healthcare for people in poverty. That will cover pre and post natal care for the mother and baby. The baby is usually covered until they're _{6. Unless you're still poor by then, in which case it usually covers the child to adulthood or until their parents no longer qualify for Medicaid. Note that none of this covers diapers, clothes, or other necessities for the infant. Just food and drs visits. If you're poor, but on the [benefits cliff](https://www.ncsl.org/human-services/introduction-to-benefits-cliffs-and-public-assistance-programs#:}:text=Benefits%20cliffs%20(the%20%E2%80%9Ccliff%20effect,a%20small%20increase%20in%20earnings.) you can get fucked lol. Murica
- To clarify, currently around ~40% of Americans have government funded insurance.
  
  5% increase since your other comment?
  
  ... which is not to say that it's free or even affordable (despite the name), or that residents in every state have equal access, or that the government is providing the plan. The ACA is a subsidy that slightly reduces the cost of private insurance, provided that you're poor enough to qualify and that your state chooses to accept the federal government's help beyond a certain threshold.

My first kid was born at 27 weeks, and would have ended up costing us 3mill if they weren't on Medicaid due to being born so early. My second kid we were living in Canada (due to my job) and basically only cost us to park at the hospital.
Growing up in the US and living in Canada for a while, I genuinely don't understand why Universal Healthcare isn't fought for more. I know it's talked about but holy fuck, it's so much better in Canada.
To comment on OP's actual question, I have no idea how people do it.
- And some fucks in Alberta want the US system because "I never get sick! My taxes are paying for someone else to be sick!"

Bankruptcy.

My son was premature and racked up 14 days in the NICU. The hospital (which is 'legally a charity' billed $250,000.00. We were low-income with no employer-provided medical insurance, so the state Medicare provider got to pay a reduced rate of that.
- You can tell what hospitals charge to out-of-pocket paying patients is predatory bullshit because the instant they receive a lower offer from insurance or state Medicare they take that lower figure. They just charge you, the private person, whatever the fuck they feel like in the hopes you'll just roll over and pay it unquestioningly.
  A good first step into bullying medical providers into negotiating your bill is getting them to admit what insurance actually pays them.
  
  Don't forget an itemized bill. They'll charge for shit they didn't do.

Once there's a kid in the equation then it's pretty easy to get on state paid insurance. It's even easier now with so called Obamacare in the equation (Affordable Care Act). If you qualify, then you'll have free neonatal care, free gyno visits, and free delivery and hospital services. It's not great insurance, like you'll be at the community hospital and not some swanky private birthing center, but it's not bad either. Medi-Cal, the California state insurance is actually pretty good for child care and birthing services. They pay for hearing aids too, which only 3% of private insurances pay for. So medical care when you're poor and have a kid is decent in the States. Now that there's Obamacare it's decent even without a kid. Where it falls short is if you're under-insured as a middle class citizen, and it's pretty easy to be uninsured, even with expensive plans.

As far as I know, Hospitals are not allowed to refuse you care; no matter what your finances are, they have to help you. Many people would go to ER for non-ER reasons because it was/is the only way for them to get treatment. (Because other medical centers can refuse you.)
The hospitals will try to get the money from you however they can and they do offer payment plans based on income. Ultimately, though, due many? The debt gets discharged to a debt collection agency that harasses you incessantly for 7 years until it gets discharged from your record.
It destroys your credit (an arbitrary number that every citizen has that supposedly shows how trustworthy they are and how much they are likely to pay you if you loan them money) until it drops off after the statute of limitations (7-10 years, depending on the state).
- Unless you enter through the ER, a healthcare system can deny you.
  Also, the ACA requires hospitals have a charity care program and notify people about it (often buried pages deep in your discharge papers). If you qualify, they’ll write off your debt and count it towards their “charity care,” which helps them justify their non-profit status, when applicable. The ACA has no rules about what charity care looks like and the hospital can set whatever criteria they want (some may have charity for those under 100% FPL, others higher).
  Source: I’m in a masters program studying this
  
  From my post: "Many people would go to the ER for non-ER reasons because it was the only way to get treatment when you didn't have the money to pay"
  Seems pretty obvious that I meant the ER...

- why is no one else mentioning home birth??

Question to Americans, is it a secret way to make poor people not have children?
- No. The rich want poor people to crack out kids to fill up the military and create downward salary pressure on the working class.
  Not to mention, being poor usually means poorly educated which means easily manipulated by the corporate media.
  
  Shhh you aren't supposed to let people in on the plan. Just think what would happen if they learned to read and saw this.
  
  That's a steady supply of cannon fodder for a couple decades.
- No I think it's the opposite. They expect people to get pregnant and have kids (though with abortion and birth control that is happening less- hence targeting those recently). This is designed to make sure they stay poor so that the wage slave class stays well populated.
- If it is, it's a bad one lol. Poor people tend to have more kids, just in general, and that doesn't change in the states.
- Actually it's easier to pay hospital bills when you're poor. You either go to a non-profit hospital and ask for charity, where they'll wipe your bill clean if you make too little, or you just don't pay the bill. What's bankruptcy if you're too poor to have credit anyways?
  
  You have never been poor have you? I can guarantee you that it is not that easy.
  Having assets and credit are too very different things. And forcing some one in to poor credit can affect them for decades. Making it difficult or impossible to do simple things like have a bank or finding a place to rent. That is why it is called a cycle of poverty. Once you get the label of poor. It can be very hard to remove that label even if you are hardworking and have a stable job. Live become more expensive making it even harder to get out of poverty.
  Plus if you think bankruptcy is an easy or quick process. I hope you never have to go through it.
  
  what about a midde class person? someone that makes enough to be able to pay 20k, but meaning that would be their savings

Ours was completely covered by state provided health insurance.

Healthcare in the US generally screws the middle, not the poor, even then it's the lower middle. The poor qualify for Medicaid which generally pays for anything major and basic healthcare, though options may be limited. The old get Medicare which covers pretty much everything outside a nursing home for fairly little out of pocket. The middle and upper class generally has decent insurance that isn't crazy expensive to have and doesn't have a ton of out of pocket costs provided by an employer.
It's the people with high deductible plans that can't or won't contribute to an hsa, and those that don't have employer provided healthcare that really get screwed.
- Idk where your coming from but as someone who had $12k in an HSA and employer medical that’s bs.
  I went to the eye doctor and needed glasses. Tried using my HSA. Nope. Not an approved medical expense. Tried paying a copay at the er. Nope not an approved medical expense. Wife got a kidney stone removed via surgery. Wanted to pay coinsurance. Nope not an approved medical expense. I needed a cpap for my sleep apnea. Nope not an approved medical expense. Year rolled over and all that money disappeared. I asked where it went and was told I either used it or lost it. So I got rid of it. Fucking garbage.
  As for the employer coverage, we had a zero dollar deductible plan. My wife gave birth last year. Ambulance ride from her work? Nope, not necessary. All the gyno visits? Nope, not necessary. The ER visit when she slipped and fell at 6 months? Nope, not necessary. The 2 week hospital stay when she went preeclamptic? Nope, not necessary. The delivery? Nope, not necessary. The NICU stay for our premature daughter? Nope, not necessary.
  I payed $1700 per PAY for my health insurance and they didn’t cover a cent from our entire family last year. We racked up over $70k in medical debt. Our MOOP was $5k/$10k and they said none of it applied.
  Hospital sent it to collections because we couldn’t fit their minimum payment of $9k/mth (fuck duke lifepoint but this is an insurance rant). We complained to the pa board of health insurance and were advised to get a lawyer but no lawyer would take it. They said it would be years to get anything back, let alone the full amount.
  We ended up proving that my employer doesn’t offer comprehensive insurance. The main component is covering pre and post natal care which they claim to, but they deny every time. So now we have insurance through penni for $60/mth with government help. Oh and we went through bankruptcy to get rid of the collections debt.
  Fuck Cigna, fuck duke lifepoint, fuck insurance, fuck for profit healthcare, fuck the American healthcare system.
  
  I mean yeah fuck insurance but everyone of those things you listed is definitely covered by HSA. I use my HSA every year for glasses, hospital bills and doctors appointments. also it sounds like you had an FSA since you lost what you didn't spend. HSA has rollover. But all those expenses you listed are also eligible for FSA.
  
  Those are definitely all HSA things, and something I use mine for all the time. Dunno how it worked for you but I basically just have a debit card I can use that has my HSA balance on it. Functions like any other card.

Part of the issue with healthcare costs in the US is that many people never pay. That means those with insurance have to cover them via higher prices.
- Most of those higher prices come from insurance companies only paying a percentage of what they are billed, and the cost of the staff involved with dealing with those companies.
- I wonder how much impact the cost of nonpayment has on the end user vs the cost of the middle men and insurance administration itself.

One thing others haven’t mentioned: most states accepted the ACA Medicaid expansion, which means most poor people qualify for Medicaid (at least in 80%ish of states). Medicaid is pretty cheap out of pocket. It can get complicated around who accepts the insurance, but almost any hospital where you go to give birth will.

Honestly, in Arizona surprisingly, the state paid for it because we were poor and eligible for their healthcare programs. I know its bad everywhere here, but we got lucky.

I left one job and went to another. There was a 3 month gap where I had no health insurance, didn’t qualify right away at the new job. Got an infection that required a two week round of antibiotics.
The cost without insurance was a little over $2000. My COBRA coverage was $600+ and a couple dollars with insurance for the anti biotics. I felt lucky to only have to spend the $600+ to enact COBRA coverage and that it happened in the first month so I could only pay once and drop it.
- Is that where you send a big snake into the medical billing goons' office to distract and/or eat them?

The number one reason for bankruptcy in the USA is due to medical debt.
We just go into debt, is your answer.

Here you go. This might answer some questions you have https://www.healthcare.gov/what-if-im-pregnant-or-plan-to-get-pregnant

Same with any hospital visit here afaik. Most hospitals have a loophole if you can't pay, you can dispute the fees, they check your income, etc.. like others have said I think it affects your credit score either way. But it's all part of the privatized healthcare grift.

Bathtub. Car. Alleyway. Crippling debt that, while shouldn't be impactful on credit score, will still follow you for your lifetime.

I haven't looked too deep into it because I don't plan on having children, but it's probably cheaper to have the kid at home. I've met a couple people who opted for the home birth and they were glad they did.
(I've also just personally always thought giving birth in the bath with water would be the way to go if I ever did it. Feelings that it might be easier for baby to be born into water and not directly into cold air after being in the warm amniotic fluid so long.)

The average out-of-pocket payment is under 3k.
- You say that like it's not supposed to say over 2.5k. Making any price under something makes it seem cheap. And let's not forget that the majority in the US don't have 1k in their bank at the end of the month.
  
  I say that because the average was some number that hadn't reached 3k.

dunno, my sister hired a midwife to handle the birth. i heard it was cheaper than a hospital visit but I have no idea of the actual cost.

You generally don't pay for hospital visits 95+% of people have some form of insurance that would cover the vast majority of the cost for going to hospitals for giving birth.
- 95% of people have insurance? Does not caring about medical debt you'll never pay count as insurance now, because thats the only way that number makes sense. Unless i missed your point, which im known to do.
  
  Sorry it was 91.4%

Babies and births were things before money was a thing.

The same way anyone else does you go to the hospital. They are required to provide anyone with medical care especially in emergency situations.
Many hospitals in the us simply offer these kinds of medical things for free, if one qualifies.
The difference is at the end of the medical procedures one could get slapped with a medical bill... That one can discard outright. Medical dept is more often than not forgiven or forgotten by the hospital. It could be reported on your credit history but that is also often times overlooked or not calculated by the credit reporting agency.
America basically has universal healthcare. Of course there are very serious situations concerning long term care and unorthodox or experimental procedures that can be denied if they aren't paid for.
And don't get me wrong the health care system in America is a travesty and a human and civil rights issue that needs to be resolved!
I'm just saying you're not gonna die if they can help it.
- Stupid question: can you just not tell them who you are?
  
  Nope. You will have to fill out paperwork after triage and before being put in a bed.
  You can be prosecuted for fraud for providing false info.
  
  If you want to give birth in the hospital they're going to need to create a birth certificate. That probably requires ID.
  Otherwise if you just get dropped off at the front door of the emergency room with no ID on you, you'll get treated as a John Doe. Basically, unidentified person needs assistance. I don't know how exactly that situation works its way through the billing department.
  
  For stuff like in and out treatment you can but if you need ongoing care or prescriptions it would be difficult and either way if you get caught you are gonna get in trouble, fines, possible jail time so it's best to just give your real info and just not pay or plead your case with the indigent fund hospitals usually have. All that said I've known plenty of people who have given fake info and have had no repercussions
- I'm just saying you're not gonna die if they can help it.
  Dead people can't pay, so it's in their interests to keep you alive.
- So no. What you have said is a lie. I have no idea what motivation you have by making something this up but you did and you should be ashamed.
  If a woman in labor enters a hospital in the United States they are legally required by law to deliver the baby regardless of how the person can pay.
  Later after the woman and baby are discharged they can send them bills for the medical procedures whatever those maybe and yes they have the option of going after that debt in whatever way our legal system allows them to.
  What I am saying is, specifically for medical debt they don't often go after especially in emergency situations and end of life situations.