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Part: 3

Push Is On to Cover Prenatal Care in Health Plan

Thursday, August 27, 2009

Health advocates are rallying in New York on August 29 to push for broader health coverage. One goal: ending the practice of treating a woman's pregnancy as a pre-existing condition that bars obstetric insurance coverage. First of two stories.

Subhead: 
Health advocates are rallying in New York on August 29 to push for broader health coverage. One goal: ending the practice of treating a woman's pregnancy as a pre-existing condition that bars obstetric insurance coverage. First of two stories.



Health advocates are rallying in New York on August 29 to push for broader health coverage. One goal: ending the practice of treating a woman's pregnancy as a pre-existing condition that bars obstetric insurance coverage. First of two stories.

Cindy Pearson

(WOMENSENEWS)--As President Obama and Congress battle over the fate of health care reform, advocates for women's health are working hard to ensure that the final bill will prohibit gender discrimination in insurance coverage that can prevent pregnant women from obtaining obstetrical care.

"Women must keep their voices loud and strong, so that the angry people who disrupted the congressional town hall meetings won't succeed in sabotaging the proposed reforms," said Cindy Pearson, executive director of the Washington-based National Women's Health Network, an organization of 8,000 individuals and organizations founded in 1975 to give women greater support within the health care system.

Paying for maternal care after an insurance carrier denies benefits requires ingenuity. Some women whose employer-paid or individual policies do not cover prenatal care and childbirth tap their savings. Others put the expenses on their credit cards or take out loans or borrow from friends and relatives. Still others rely upon public programs or charity care.

It is difficult to say how many women go through this.

The American College of Obstetricians and Gynecologists, a 53,000-member organization of physicians and other clinicians, estimates that 13 percent of all pregnant women are uninsured.

Expensive Exclusions

A woman's health history, such as a previous Caesarian section, can make her ineligible for a company or an individual policy.

Even women who have insurance face problems. Some plans exclude maternity care. Some women don't qualify for maternity benefits because they haven't held their jobs long enough to qualify.

The July 31 bill reported by the Energy and Commerce Committee--the last of three panels with jurisdiction over health policy in the House--prohibits insurance companies from classifying pregnancy as a pre-existing condition.

But Pearson said women can't assume that insurance companies will no longer be able to deny, delay or make maternity care prohibitively expensive.

Raising Women's Voices, a coalition of the National Women's Health Network and other progressive organizations, will hold a rally Aug. 29 in New York City's Times Square highlighting the need for insurance reforms.

Twenty-one million American women and girls lack health care insurance; another 14 million rely upon individual policies, which are more expensive and less likely to provide maternal care than employee-provided insurance.

Big Gaps in Who Pays

People who buy individual insurance shoulder 48 percent of their health costs out-of-pocket compared to 22 percent for people in employer-provided plans.

Many new mothers are burdened by thousands of dollars in debts because an individual policy might cap pregnancy coverage at $2,000, but the cost of a complicated delivery and post-natal care for a premature or low-weight baby might be over $50,000.

The American College of Obstetricians and Gynecologists has been conducting a phone and e-mail campaign to Congress, stressing that the bill that is expected to emerge in September must guarantee uniform maternity benefits for all women in every private and public insurance plan.

"Although the House seems receptive to a reformed health care system that will guarantee prenatal care for all women, it is more difficult to predict what the Senate will support," said Dr. Gerald F. Joseph Jr., president of the Washington-based professional organization, which has supported universal coverage for maternal care since the early 1970s. "It is crucial that the legislation prohibit insurers from considering pregnancy as a preexisting condition."

Sharon Johnson is a New York freelance writer.

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For more information:

ACOG's Coverage for All Women page
http://www.acog.org/departments/dept-web/dfm?recno=44

National Women's Health Network
http://www.nwhn.org/

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