By Sarah Lovenheim
Yesterday, the Department of Health and Human Services Secretary Sylvia Burwell said that she “is happy to consider” our request to classify pregnancy as a qualifying event for women without maternity coverage to get covered outside of Open Enrollment.
This is a big deal for health advocates and an even greater deal for the millions of uninsured women across the country, who risk their health and financial wellbeing when they become pregnant.
Millions of women get pregnant each year and many still have grandfathered or so-called “transitional” plans that do not cover maternity care. With roughly 50 percent of pregnancies unplanned, a women may not know her plan doesn’t cover maternity care until it’s too late to sign up for a different coverage.
The popular TV show, Dowton Abbey, has rightfully drawn attention to a disease that can result when pregnant women lack maternity care: preeclampsia. It killed a daughter of royalty on the show – Lady Sybil. She was able to give birth after experiencing hypertension but fell into convulsions and died the same day.
The executive director of the Preeclampsia Foundation, Eleni Tsigas, recently remarked that preeclampsia is “a very serious complication of pregnancy that puts both the mother’s life and the baby’s life at risk.”
The show takes place in the 1920s when many women lacked health insurance. It was only in the 1930s that doctors began regular monthly prenatal visits to pregnant women, which became a way to detect preeclampsia. We’ve come a long way as a society but not far enough. Women without maternity coverage may not be able to afford to pay out-of-pocket for prenatal care that’s available today.
A pregnant woman without insurance can pay anywhere from $10,000 to $20,000 in medical fees during pregnancy and delivery, without complications.
Preeclampsia isn’t the only disease that can result from pregnant women lacking maternity care. Placental abruption, diabetes, heart conditions, and Graves’ disease can also result. These conditions are rare but as with preeclampsia, they can prove fatal for the mother, fetus or both.
No expecting mother should have to risk such grave health challenges. We’re urging the Department of Health and Human Services to make pregnancy a life-qualifying event for Special Enrollment. This would mean giving women who become pregnant the opportunity to sign up for health insurance plans that include maternity coverage outside of the Open Enrollment period.
Insurers argue that it’s more costly to cover more people outside of Open Enrollment but the cost of covering a woman’s health needs who has developed a disease as a result of no maternity care after the fact may be far worse. Maternity coverage isn’t just critical for soon-to-be-mothers, but for the health of their newborns, too.