The Health Reform Law Means that Women Have Insurance for Maternity Care
In 2009 as I was gearing up to move to DC I had a conversation with a potential roommate who told me about why she went without maternity coverage. She had health insurance, but it did not include maternity care unless she purchased a separate rider. The rider was basically a trick. You had to buy it for months before you even got pregnant and continue to pay extra for it throughout the pregnancy. The kicker is that benefits were capped at just $5,000. Counting additional premiums and out of pocket costs, she would have paid more if she bought a maternity rider than if she didn’t! Luckily she read the contract carefully and did the math before forking over premiums. Even more fortunately, she had a good job and an uncomplicated pregnancy and delivery, so she was able to afford to pay out of pocket.
But that conversation gave me a new worry. It had never occurred to me that regular health insurance might exclude maternity care, a pretty basic health service. Now in addition to thinking about my biological clock, the timing of babies depended on making sure I had insurance coverage. And after I started working at the NWLC, I learned the shocking truth: only 13% of individual market health plans provided any coverage for maternity care!
Luckily for me, those worries were short lived. Health reform requires maternity care to be included in all individual and small group insurance plans starting in 2014 as an “essential health benefit.” The end of gender rating means the fiscal burden of reproduction will be spread among everyone (just like everyone helps pay for health issues men are more likely to have). In addition, there will be no co-pay for preventive care, including maternity-specific preventive care. Finally, protection from benefit caps mean that I won’t worry that complications could leave me bankrupt. All of this leads to peace of mind for me, knowing that I can change jobs or even stay home without worrying about whether I can find insurance that covers maternity. And it means that I’ll never have to risk going without maternity coverage.
Meanwhile, premium assistance and Medicaid will help ensure that women don’t have to forego health insurance altogether. And for lower income women, Medicaid is required to cover a wider range of birthing options, including freestanding birth centers. More covered women means more prenatal care and better health outcomes for moms and kids. There’s nothing more family values than valuing maternal health.
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