Up until now, most individual health insurance plans have offered maternity coverage only as a costly "add on" service. Being a woman is not a pre-existing condition, came the cry from women's advocacy groups.
But a new law, SB 222, requires all private plans to include maternity benefits as standard. California put the regulation into effect July 1, pre-empting the Affordable Care Act, which will require all insurance plans to include maternity benefits by 2014.
As a result of the mandatory benefit, health insurance premiums are expected to increase by an estimated $7 a month per policy. Proponents of the law, however, say that upped costs will be offset by savings to taxpayers who currently fund government health insurance programs for uninsured and underinsured pregnant women.
California currently provides pregancy-only Medi-Cal health coverage for pregnant women, including undocumented immigrants, with a family income at or below 200 percent of the federal poverty guideline. Expectant mothers with a higher family income may be eligible for the Access for Infants and Mothers (AIM) program, which provides maternity coverage for women without relevant plans or for those with plans that include a deductible or co-payments of $500 or more.
SB 222 was passed by California legislators in September 2011 and stipulates that maternity coverage must include:
- Prenatal care
- Ambulatory care
- Involuntary complications of pregnancy
- Neonatal care
- Inpatient hospital maternity care, including labor, delivery and postpartum care
"Women should have access to proper medical care throughout their pregnancy," said Deniene Erickson, media relations specialist for Kaiser Permanente, in a statement to Patch. "Such care is essential to the health and well-being of both the mother and the child."
Erickson added that services provided during prenatal care, such as smoking cessation and diabetes screening and treatment, are imperative to ensuring a healthy pregnancy. Through SB 222, California has had "an incredible opportunity to be a leader," said Erickson, "and help thousands of women and families have healthy, affordable pregnancies until the federal requirement begins in 2014."
Are you a mother whose health insurance plan didn't cover your pregnancy? How did you cope? Share your story in the comments.
How do you feel about individual health insurance premiums increasing to cover maternity care? Let us know in the comments.