Friday, September 18, 2009

Health care costs for pregnant women and families

Sobering statistics about health insurance for women and families:

* The majority of individual health care plans (i.e. policies people without employer-based coverage buy on their own) do not cover maternity care. According to a study by the National Women's Law Center, only 12 percent out of more than 3,500 individual insurance market plans offered comprehensive maternity coverage. Unlike an employer-sponsored group plan, which can't discriminate based on gender or age (i.e. those policies have to cover everyone in the pool), plans sold on the private market can have a "female-only maternity exclusion." Only 14 states require that plans sold on the individual market include maternity care.

Women who want a plan with maternity coverage are charged astronomical premiums, often for policies that have major loopholes. As an example, read writer Sarah Wildman's article Health Insurance Woes: $22,000 Bill for Having a Baby—and I had coverage for maternity care! (published on's DoubleX blog). In the piece Wildman describes how her individual market CareFirst Blue Cross Blue Shield policy's maternity coverage did not cover her labor, delivery or hospital stay. To add insult to injury: The c-section she had can now be considered a risky pre-existing condition.

Imagine having to pay out-of-pocket for all of the medical care associated with a pregnancy—from prenatal care to delivery? Imagine if you also don't have maternity leave pay from your job, or if you're self-employed, or if you have to quit a job due to the challenges of a pregnancy. (That actually happened to me.) I wonder if these no-maternity policies cover Viagra? It's likely they do, and just as likely that they don't cover birth control.

And from the National Coalition on Health Care:

* The Henry J. Kaiser Family Foundation's Employee Health Benefits: 2008 Annual Survey reports that over the past decade, employer-sponsored health insurance premiums have increased 119 percent.

* The Congressional Budget Office estimates that without health care reform, employer-based family insurance for a family of four will cost nearly $25,000 per year by 2018. Many employer-based plans receive group discounts from insurance providers, so imagine what the costs will be for an individual trying to buy a personal or family plan on the open market! Imagine paying $25,000 a year or more just for health insurance premiums, and then adding the costs of co-pays, deductibles, out-of-network care or excluded fees and services.

Ugh, I feel sick.


Lilly said...

Ugh, I feel sick, too. This is so upsetting. I have two children and both had to go to the doctor one or more times in the past two weeks for sore throats, infected bug bites, one had a strange rash. With insurance each visit costs about $75 because we haven't met our out of pocket deductible yet. (It's high, like $4000 for the family.) The insurance is through my husband's job. I worry about him losing his job. I'm a stay at home mom who is now job hunting and even the full-time jobs I've interviewed for won't come with paid health coverage. Some don't offer it at all. Others say you can buy into the plan but it's expensive. I really want health care reform to happen and for there to be a public option as an option.

Anonymous said...

That is ridiculous! Congress needs to control medical costs. I had my first child in Mexico for $800 dollars in a wonderful hospital. I had a four day stay with great nurses and better care than I got with my daughter here in the states. Health insurance won't solve anything if medical costs don't start to get regulated.


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