Thread: Families to pay price if maternity coverage gets cut in GOP's health care plan

Families to pay price if maternity coverage gets cut in GOP's health care plan

by Julie Rovner, Kaiser Health News @CNNMoneyMarch 13, 2017: 6:05 AM ET

Christie Popp, who is pregnant with her third child, is hoping hard that the maternity coverage she has through the Affordable Care Act doesn't go away.

That coverage is written into the health law as a requirement for every plan sold on the individual market. But that could change if Republicans get their way to repeal the ACA and remake health care.

Popp knows firsthand how difficult it was to find such coverage before most of the federal health law's provisions took effect in 2014. When the 37-year-old lawyer from Bloomington, Indiana, had her first child in 2011, she had health insurance through her job at a nonprofit legal clinic. Because the insurance carried a high deductible, she and her husband paid $6,000 out-of-pocket during the pregnancy and delivery.

By 2013, when her second son was born, she'd moved to individual coverage purchased after setting up her own practice.

"It was really bad insurance, and it was really expensive," she said.

To lower their out-of-pocket expenses, she and her husband decided to have a home birth with a midwife, though she still paid thousands of dollars to the physician she used as a backup.

Related: Who wins and who loses under Obamacare replacement bill

For baby No. 3, the couple's calculations will be different, she said: "This time I have real good coverage, so it's great."
If it lasts, that is.

Republicans say they want to jettison the maternity coverage requirement, which is part of the ACA's list of 10 "essential" benefits. It's a valuable benefit, and removing it outright won't be easy since it would take complicated maneuvering in the Senate to do so. It remains intact in the bill moving through Congress, but that is due to budget rules, not because Republicans want to keep it.

The total price charged for pregnancy and newborn care ranges widely but averaged about $30,000 for a vaginal delivery and $50,000 for a cesarean section, with commercial insurers paying out an average of $18,329 and $27,866.

Still, the idea of the federal government requiring insurers to offer types of coverage is anathema to many Republicans, who assert it interferes with companies' and patients' choice.

Seema Verma, the consultant on private health insurance who was nominated to head the agency that oversees the health law, said at her Senate confirmation hearing last month that she does not necessarily support keeping maternity care as a requirement for insurance plans.

"Women have to make the decisions that work best for them and their family," she said. "Some women might want maternity coverage, and some women might not want it."

Backers of the coverage requirement say that's a fundamental misunderstanding of how insurance works.

"Anytime you allow people to pick and choose, you're making the care they don't pick more expensive," said Debra Ness, president of the National Partnership for Women & Families.

Related: Insurers worry GOP bill will leave low-income Americans without coverage

"Only 12% of plans on the individual market covered maternity" before the health law, said Janel George, director of federal reproductive rights at the National Women's Law Center. "So women were saddled with having to pay for this because insurance companies didn't have to." Although many plans offered optional maternity riders, these could cost close to $1,000 per month and had to be purchased months in advance of any pregnancy.

Conservatives argue that the health law's requirement for certain benefits has caused premiums to skyrocket. But the law's supporters argue that may not be the case.

Sherry Glied, a former Obama administration health official and a dean at New York University, said that when you look at the main drivers of increases in health care spending, "most of the costs are in the conventional stuff," like inpatient hospital and doctor care.
A 2016 study for the Blue Cross and Blue Shield Association backs that up. It found that cost increases in the individual market in 2014 and 2015 were driven not by inclusion of new benefits, but by the fact that people with serious illnesses, who had been previously shut out of the market, were quick to sign up and get expensive care. By contrast, maternity care, said Glied, "comes out to something under 5%" of the average premium.

In practice, changing the health law to do away with the requirement for maternity coverage entirely would be politically hard. Among other things, it would likely need 60 votes in the Senate, including eight Democrats.

Related: Companies offering HSAs could bank on big profits under GOP plan

Still, the Trump administration could potentially weaken the requirement, by allowing states more leeway to accept less generous plans when determining if adequate benefits are being covered.

Ness said the administration also "could allow states to define their own essential health benefits standards. That would put states in the driver's seat in deciding what benefits are covered and what aren't."

That wouldn't give states a green light to allow insurers to drop maternity coverage altogether — because it is written into the federal law — but "there could be some plans that offer maybe less generous coverage."

Such a scenario would bring back the days of women who have babies and wind up covering more of their own bills.

Christie Popp, who's due in October, said she "more than hopes" nothing happens before then.

Kaiser Health News, a nonprofit health newsroom whose stories appear in news outlets nationwide, is an editorially independent part of the Kaiser Family Foundation.

http://money.cnn.com/2017/03/13/news...d=hp-stack-dom

House GOP bill would let employers require genetic tests

You won't see any tears or hear any violin playing from me!

Part of being able to afford to raise children is being able to afford having them.

If the government doesn't think it should pay for birth control, then it shouldn't have to pay for maternity care either.

Originally Posted by pkskyali

Part of being able to afford to raise children is being able to afford having them.

If the government doesn't think it should pay for birth control, then it shouldn't have to pay for maternity care either.

I believe maternity care should be a part of any good healthcare insurance policy. Without insurance coverage many middle class families will find it very difficult, if not impossible, to birth future generations of Americans. However, the illegals will still be delivering them like rabbits free of charge through hospital emergency rooms. Would they really benefit our country?

While we do have to work with reality and with the situation as it is - not as it should be.

We should not be paying for the births of illegals - period.

The government should not be able to mandate what an insurance company offers or what coverage a person should have to purchase.

The total price charged for pregnancy and newborn care ranges widely but averaged about $30,000 for a vaginal delivery and $50,000 for a cesarean section, with commercial insurers paying out an average of $18,329 and $27,866.

Hmmm.

Excerpt from WebMD article:

Hospital Expenses

The cost of having a baby can really add up at the hospital. You should make sure you are well-prepared financially for this part of pregnancy, especially if you don't have health insurance.

The costs of childbirth can be steep. The charge for an uncomplicated cesarean section was about $15,800 in 2008. An uncomplicated vaginal birth cost about $9,600, government data show.

http://www.webmd.com/baby/features/c...aving-a-baby#2

The "rising cost of health care" as a result of Obamacare. These procedures were much much cheaper in 2008 before the ACA passed. About 1/3 to 1/4 depending on the procedure.

It's like college tuition. The more government financing of it that's available, the higher the price of it goes. It's the same with government subsidized medical procedures. The more government funding available for it, the higher the price of it goes.

Like most hospitals, most colleges are 501 C 3's or state or government owned. So you thought it was those mean ole insurance companies and banks that left you with these enormous bills for pretty common stuff, learning and breeding, something humans have been doing for millions of years virtually for free?

This is the distorted result of incestuous relationships between government, those they fund, and those who end up with the money. When having a baby cost $9,600 in 2008 before Obamacare and now costs $30,000 and a C-Section cost $15,800 before Obamacare and now costs $50,000 ... who benefited? Well, your local "charity" or government owned hospital got the money, it's "charity" and the government benefiting. The insurance companies didn't benefit, most of them went broke. It wasn't the patients, they've got ripped off with deductibles and co-pays they'll be paying off until their kids are in high school.

This example alone is proof beyond measure that Obamacare has to go, Phase 1, get rid of the individual and employer mandates, Phase 2, get rid of the bad regulations and Phase 3, repeal McCarran-Ferguson and get the caps off of HSA's. The tax credits in lieu of a subsidy make sense to me. The block grants to states for Medicaid makes sense to me. Maybe soon after all 3 phases are in play, the government can repeal the tax credits and get back to the way it used to be with a few improvements like prohibiting exclusion for pre-existing conditions, dropped coverage because you got sick, and rescission without cause.

Today, employers who offer insurance as part of their benefits package, something good employers have been doing for many many years, decades and decades, seem to be doing a great job, you hear no complaints about that insurance which is the bulk of private insurance, like 90% or more of it. The problem is with the Obamacare exchanges that serve approximately 11.4 million people out of 330 million. Most people who have Medicare are very happy with it especially if they have a retirement plan that picks up most of the difference or a supplemental policy that does that as well. Unfortunately we've learned that Obamacare even messed up the supplemental policies for Medicare!!

Sounds to me like we need a big group policy for self-employed persons/families and another one for not employed or employed but not insured persons/families, who aren't eligible for Medicaid. You just need two more huge groups of private insurance sold on a national interstate basis. This is so many people, of all different ages, that it would be a very profitable low rate insurance group that could and would provide a full range of services with small deductibles for hospitalization, tests and a few doctor's visits.

Oh geez, this is like Deja Vu all over again. I remember posting this same stuff back during the Bush Administration.

Well, I'm very sorry for the people who have been ripped off, and ripped off they've been, but it actually wasn't by the insurance companies, it was by the government and charity-based medical providers, especially hospitals. Just like our students are being ripped off by our government and colleges and universities.

Ironic isn't it? The complete Opposite of what should have been from our government and "charities".

Period of Ironies and Opposites.

I'll be glad when we're through with this horrible period in our history.