The grim reality of pregnancy and health insurance
Posted at 5:00 PM Aug 24, 2009
By Andrea Grimes |
Because pregnancy can be classified as a pre-existing condition, private health insurers can--and almost always do--reject pregnant women who seek insurance. Which seems like it might come in handy when you consider that a typical hospital birth can cost around $10,000 (prenatal care not included). The very limited solution? Get insurance before you get pregnant ... if you can afford it, that is:
Many women couldn't afford whatever care they find, since companies often charge women more--in one case as much as 140 percent more--for the same health coverage, according to a 2008 study by the National Women's Law Center. And only the lucky have the privilege of paying even these high prices, since companies can simply reject women for anything from having been subject to domestic violence to having had a C-section. Meanwhile, the vast majority of individual plans don't even offer maternity coverage. Only 7 percent of women get insurance through the individual market, yet its unwelcoming practices clearly contribute to the fact that another 18 percent are uninsured.And even if pregnant women qualify for Medicaid, "they can wind up without prenatal care for long periods, since twenty states lack laws allowing pregnant women to receive time-sensitive coverage while waiting for approval of their Medicaid applications." Sorry, baby. You sit tight while this bureaucracy creeps along.
Perhaps the most disturbing part of the article deals with the deceptive, downright shameful, pretty much criminal acts of fake health insurance companies like Affordable Health Care Options and Ameriplan, both of which target pregnant women. The companies amount to little more than a multi-level marketing scheme selling discount health care cards that aren't actually redeemable anywhere. So, uh, health care reform to the rescue, right? Kind of:
By forbidding real insurers from denying coverage on the grounds of pre-existing conditions, as four of the five proposals now floating around the various Congressional committees would, reform should eliminate pregnant women's desperate search for coverage. Most of those bills would also outlaw the practice of "gender rating," or charging women more for the same policies, though the Senate Finance Committee version would reportedly allow insurers to charge companies with more than fifty employees more for women.Ah, glorious. Because if we couldn't still stick it to women, just a little bit, that wouldn't be any fun, would it?
Comments
When I was pregnant 2.5 years ago, I almost lost my group insurance. I did a lot of research, and at that time pregnancy was covered as NOT a pre-existing condition b/c of HIPAA (one of Clinton's many underrated legacies). Have things changed since then? Did Bush somehow undo that...?
Posted 08/24/2009 at 05:23:40 PMJulie,
HIPAA has nothing to do with pregnancy or pre-existing conditions-it's the health information privacy rules.
Gail Neuman RNC BSN
Posted 08/25/2009 at 01:07:19 AMAdministrator/student midwife
Orange County Maternity Center
1210 S. State College Bl., Suite D
Anaheim, CA 92806
Men and women are different, and women do cost more to insure; therefore, it's a bit weird to think they should be charged the same.
Requiring a company to offer insurance to pregnant women is likely to cause them to offer it at premiums of, say, $1,250/month because that's the only way to make money with a highly likely $10,000 bill upcoming. That is still better, since it spreads the risk of non-simple delivery.
That said, an insurance company with foresight could apply a cell phone plan model, require coverage of the infant for n years after, and split the cost of pregnancy expenses between the mother's insurance and the child's. I'd imagine there's an obscure law forbidding n-year commitments, though.
Posted 08/25/2009 at 08:23:05 AMAlso, http://en.wikipedia.org/wiki/HIPAA#Title_I:_Health_Care_Access.2C_Portability.2C_and_Renewability calls you a liar, Gail.
Posted 08/25/2009 at 08:23:52 AMGail, the privacy laws are a part of HIPAA, but it covers other things as well. In addition to MMC's link:
"Under a law known as HIPAA, the Health Insurance Portability and Accountability Act of 1996, health insurers cannot consider pregnancy a preexisting condition."
http://parenting.ivillage.com/pregnancy/phealthcare/0,,midwife_46wb,00.html#ixzz0PE2NKaJr
Or straight from the gub'mint:
"Are there illnesses or injuries that cannot be subject to a preexisting condition exclusion?
Pregnancy, even if the woman had no prior coverage before enrolling in her current employer's plan."
http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html
So I repeat my question. Have things changed lately?
Posted 08/25/2009 at 12:42:56 PMI guess all the health insurance was also useful for every pregnant woman ....
Posted 08/31/2009 at 03:23:36 AMMaybe insurers concerned about the cost of pregnancy and childbirth should start promoting birth centers and midwifery care for low-risk women, which are typically much cheaper options than (which are just as safe as) a simple vaginal delivery in a hospital.
Posted 09/01/2009 at 04:04:09 PMIts really required everybody should know about its importance and have to think about their future.
Posted 09/08/2009 at 06:24:23 AMAll insurance policies are good for nothing. If they can't provide security to a pregnant woman they have no right to do the business. It is very annoying when they ignore it.
Posted 09/10/2009 at 05:53:15 AM