A new option for expectant mothers could save in the thousands of dollars on hospital and doctor bills, and help ensure healthier and safer births in the United States. Last summer’s new ruling opened up the possibility for pregnant women to choose from different coverage programs, and now that the computers have caught up, they are ready to allow women to reap the benefits.
Lower-income women who signed up for a private policy in the new health insurance marketplaces, also called health exchanges, will be able to acquire additional coverage. It would create a type of safety net for pregnant women in order to help pay fees in addition to paying for their private insurance, according to the American Pregancy Association.
The health insurance marketplaces are organizations set up in each state for people to purchase health insurance plans in accordance with the Patient Protection and Affordable Care Act, also known as Obamacare. There have been over eight million people who signed up for a private insurance plan as of April 19, 2014, and an additional 4.8 million people enrolled in Medicaid as of March 31.
Now expectant mothers will have a choice: They can either choose to give birth under limited insurance coverage or sign up for a private policy in the new health insurance marketplace if they qualify. If she choses the latter, she would not have to worry about her coverage running out after the baby is born, which is what would happen if she stayed insured under Medicaid's old maternity-only coverage. In 2011, there were approximately 3.94 million births in the U.S., and of those, nearly half were paid for by Medicaid.
"A lot of women, particularly in a situation like childbirth, could end up with significant out-of-pocket costs," said Cynthia Pellegrini, the head of the March of Dimes’ Washington office. "If they are eligible for Medicaid, they could be protected from costs ranging from hundreds to thousands of dollars."
March of Dimes was originally founded as the National Foundation for Infantile Paralysis by President Franklin Roosevelt, who had his own personal struggles with polio. Once the vaccine for polio was developed thanks to the program, the foundation turned its focus to preventing premature births, birth defects, and infant mortality, according to its website.
According to Pellegrini, the cost of the normal smooth and healthy childbirth averages to $5,000, but copayments and deductibles add up fast, which makes it difficult for expectant mothers to predict birth costs. One out of every eight babies is born preterm, which is the birth of an infant before reaching 37 weeks of pregnancy. Preterm births can cost 10 times more than a normal birth, and in 2005 cost the U.S. health care system more than $26 billion, according to the Centers for Disease Control and Prevention (CDC).
Prenatal care, medical attention throughout the pregnancy, and avoiding smoking and drinking are all of the most important steps to help reduce the risk of preterm births, according to the CDC.
Prior to the new health law, states offered time-limited coverage to uninsured mothers-to-be who were beneath the poverty line and some states provided the benefits to their middle-class women as well. Time ran out once their baby was born.
"Usually you could only be in one or the other," said Dipti Singh, an attorney with the National Health Law Program in Los Angeles. "This is different in that pregnant women are eligible for both."
The difference is, when the Affordable Care Act came into play, it only supplemented private insurance plans for people who didn’t have coverage from their employer. However, if you’re eligible for Medicaid, you’re usually not also allowed to tap into the government-subsidized private insurance option. But once the Treasury Department ruled Medicaid’s insurance coverage for pregnant women didn’t meet the definition of “minimum essential coverage” because each state could pick and choose what they wanted to cover, they decided to give women another option.
Expectant mothers needed more than just the minimum, which is why the ruling last summer gave women the option to benefit from either a subsidized private health insurance coverage or Medicaid. However, when the ruling came, it too late and they didn’t program it into the computer as an option for women. Now it’s up to policy makers and advocates to advertise the new benefit options to pregnant women.
"This is an issue where women are going to have to figure out, 'I'm eligible for both, now how do I do that?'" said Matt Salo, executive director of the National Association of Medicaid Directors, which represents state programs. "But what a wonderful problem to have. This is a great problem to have from the consumer's perspective."