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 Although the Affordable Care Act requires large, company-based
health plans to cover maternity services, these plans are free to
pass along some of those costs to women in the form of copayments
and deductibles.
As a result, the estimated average cost of having a baby for women
with health insurance through their employer rose to $4,569 in 2015,
up from $3,069 in 2008, according to a report in the journal Health
Affairs.
"We found that between 2008 to 2015, 98% of women had some
out-of-pocket costs for maternity care. This was a universal
phenomenon," coauthor Dr. Michelle Moniz, of the University of
Michigan's Institute of Healthcare Policy, said in a telephone
interview with Reuters Health. "These are really big financial
burdens for people."
The study included a national sample of 657,061 women enrolled in
84,178 employer-sponsored plans who had been hospitalized for
childbirth from 2008 to 2015.
The team analyzed costs for all healthcare services used before and
after delivery that could play a role in the success and health of
the woman and her child.
Estimated out-of-pocket costs for cesarean sections were higher than
for vaginal births, with average out-of-pocket spending rising from
$3,364 in 2008 to $5,161 in 2015. That compared with an estimated
average cost of $2,910 in 2008 for vaginal births, a figure that
rose to $4,314 in 2015.
"This paper provides new data on out-of-pocket spending for
maternity care under employer-sponsored insurance, which is the
leading form of coverage for reproductive age women," Usha Ranji,
associate director for women's health policy at the Henry J. Kaiser
Family Foundation (KFF), said in an email to Reuters Health.
She said the increase tracks with data from the KFF Employer Health
Benefits Survey, which shows that nationally, 82% of covered workers
have an annual deductible, and deductible levels have been rising.
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Ranji said the average annual deductible among covered workers with
a deductible increased 100% over the past decade.
"Having a baby is the most common reason for hospitalization in the
U.S., and even with private insurance, women could face significant
out-of-pocket costs when they have a baby," she said.
A limitation of the study is that it used standardized costs, which
reflect allowed payments, and not actual charges or payments.
Even so, Moniz said the findings are concerning because cost is one
reason many women might defer or skip needed care, which leads to
poor outcomes for mother and baby.
Already, the United States has the highest rate of pregnancy-related
deaths in the developed world, with some 700 women dying each year
from pregnancy complications, according to the Centers for Disease
Control and Prevention.
The study is the first to quantify maternity costs in the post-ACA
era, Moniz said, and it raises concerns that in spite of long-stated
goals, U.S. policy still does not provide adequate coverage for
maternity care.
"These are essential services to ensure every baby gets a healthy
start in life and that families do well," she said.
SOURCE: http://bit.ly/2QzNQiP Health Affairs, online January 6,
2020.
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