How much would female reproductive health cost in your state without Obamacare?

Until the GOP manages to overhaul it, Obamacare requires that certain preventive reproductive services for women are covered by insurance, with no co-pay. These services include birth control, UTI screenings, folic acid supplements, PAP smears, and breast cancer screening.

Women who have insurance typically pay $0 across the country to access these services—although there is no guarantee they won’t be rolled back, as happened with birth control benefits, which the Trump administration made optional for employers on the basis of religious and moral grounds.

For a woman taking birth control, the cost without the Affordable Care Act would be between $120 and $2,196, depending on the method, and the state.

Service No insurance (min) No insurance (max) Insurance
Birth control $120 $2,196 $0
Pap tests $175 $497 $0
STI tests $116 $136 $0
Breast cancer screenings $493 $5,531 $0
UTI screenings $15 $15 $0
Well-woman visits $296 $460 $0

If any further rollback of the Affordable Care Act provisions are put into place, services covered would vary dramatically by state. Women’s health advisory company Tia evaluated what they call “Vagina Benefits”—or health benefits required by people with vaginas—to see what US states would provide women in the absence of a federal mandate.

Tia analyzed each US state, highlighting what services would no longer be covered and listing what laws are in place. New York state would be the best state in terms of female reproductive health benefits, providing full coverage of birth control and other preventive services. On the other end of the spectrum is Utah, which would cover absolutely nothing—making it the worst state for women’s health. Utah also has a high likelihood of employers claiming religious exceptions from providing birth control.

Overall, only 10 states would have a sufficient level of coverage, while the majority would be limited to cover only certain types of birth control—if any. According to Tia’s calculations, then, without federal compulsory coverage, a woman would have to pay between $1,213 and $8,835 per year, or between 3.6% and 26.4% of the average salary of women in childbearing age.