Who Covered the Cost of Your Maternity Care?

A new California law effective July 1 requires maternity care to be included in all private health insurance plans. Previously, less than 15 percent of individual plans covered pregnancy, child birth and postnatal care.

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.

David H. Perez July 12, 2012 at 12:26 AM
I am completely willing to pay a few dollars more for my medical care to give women full access to medical care throughout their pregnancy. However, I do not agree that illegal immigrants should be entitled to this.
Cathy P. July 12, 2012 at 09:26 PM
I don't have any biological children of my own (Foster only) but it made me wonder how my parents paid for maternity care. Back in the Dark Ages when I was born, I don't remember either my Dad or Mom having "health care" through where they worked. Of course, the cost of having a baby must have been cheaper then than today. I also am totally willing to pay extra to ensure that women have full access to medical care before, during, and after pregnancy. That's a no-brainer for me.
Watzon McWats July 13, 2012 at 01:11 AM
This is a tough one for me. By and large, folks elect to have children. It's not like a car accident or flu where one has limited control over it's occurrence. My thoughts regarding children in general are that if you can't afford to have them, don't. It shouldn't be up to everyone else to subsidize your costs, some of those folks being responsible couples that have held off having children because they too can't afford it. But then again, other preventable medical expenses such as the emphysema from smoking or type 2 diabetes are typically covered, so with that in mind, it's hard to argue that maternity shouldn't be. Funky world we live in. If nothing else, if a load is to be shared, it's probably better than the private sector handle it than the government.


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