Maternity Care and Health Care Reform
Filed under: Medicaid, Private Insurance, Proposed Legislation
In the last few weeks, health reform has been receiving more public attention than it had before, much of which can be attributed to President Obama’s efforts to unify Congress in passing a bill. For consumers, the politics of reform have helped to blur the defining components of each reform bill, leaving them unsure of what their health care insurance will or will not cover (let alone how they will pay for it) if reform is passed. This is a real frightening thought considering that consumers will be the ones directly affected by whatever Congress decides. In most American family units, the women make the majority of health care decisions for the rest of the family; women also have a lot at stake when it comes to their own health care access. For these reasons, it is essential for women to understand and know what their legislators are planning for their health.
One of the areas of women’s health care that certainly needs to be reformed is maternity care. Currently, women in the individual market can be denied health coverage if they seek coverage after becoming pregnant. And that’s not the only pregnancy related preexisting condition out there – if you’ve had a C-section before, you could be charged far greater premiums or even denied health coverage altogether. It may seem that women who are uninsured are the only ones that would have to deal with such scenarios; however, women with insurance from the individual market or employer-based insurance face similar challenges in accessing care. Read this story about a woman who had coverage through a private insurer and still had to pay $22,000 for having a baby.
Among the different types of private insurance that women have (or can have), there are major discrepancies with regard to maternal health coverage. You are most likely best-off if you have employer-based insurance; best being a relative term. Protection from discrimination in employer-based coverage exists through the Pregnancy Discrimination Act of 1978, which made any pregnancy-based discrimination unlawful. However, the individual market is another story altogether. The Pregnancy Discrimination Act and a number of other consumer safeguard regulations do not apply to the individual market. States allow for insurance companies in the individual market to calculate premiums based on categories like gender, age, and pregnancy status.
The issue of access to maternity care for uninsured women, however, is surely the case of the worst-off. The obvious translation here is poor prenatal care, which is a vital aspect of not only the mother’s health but the child’s as well. Considering the fact that our country has one of the highest infant mortality rates among developed nations, the need for reform to address maternity care for the uninsured is a serious one. While Medicaid is able to assist in covering some of these uninsured women, a large overhaul of the maternity health care services of public programs like Medicaid should be requisite within national health care reform.
Congressional health reform proposals have not yet fully revealed what they will do to ameliorate the maternity health challenges that women face in our country. However, we do know that certain systems have historically served women’s maternity health care needs better than others. At this point in the national health care reform stage, women should be particularly concerned with the type of reform that Congress will pass.
Any health reform or insurance plan legislation which fails to provide access to care to ensure healthy pregnancies should be seen as strongly suspect-as this fundamental disregard for the basic needs of women (and children), dire in itself, would surely be a harbinger for a further disregard of women’s rights going forward.