Health Insurers Routinely Deny Coverage for Pregnant Women

Pregnancy is supposed to be one of the most exciting times in expectant parents' lives, but, thanks to our cut-throat, no-care insurance system, it can be one of the most stressful. Big insurance companies see pregnancy as a burden, and a recent investigation finds that they deny women critical coverage because of it.

Findings from a House Energy and Commerce Committee investigation, released Tuesday, show that the individual health insurance market denies pregnant women coverage and limits their ability to purchase maternity care. The four largest for-profit insurance companies, Aetna, Humana, UnitedHealth Group and WellPoint, listed pregnancy as a medical condition "that would result in automatic denial of individual health insurance coverage."

Not only are women denied coverage because they are pregnant, maternity care is often excluded from coverage in the individual market. What does this mean for a woman? Even if she isn't pregnant, she is unable to purchase a plan that would cover maternity care in the future. Without coverage through work or on a partner's plan, expectant moms face paying out of pocket for necessary prenatal care and delivery costs.

And it's not just women that are denied care. The report also find that "expectant fathers and families attempting to adopt children are generally unable to obtain health insurance in the individual market."

Without maternity coverage, women can choose to purchase a "rider," an add-on type of insurance. But this offers limited coverage and can be expensive. For instance, after four years of paying premiums, an insured women won't get more than $6,000 from the company, even though her pregnancy-related medical claims may be much higher.

The American Pregnancy Association (APA) estimates that the cost of delivery alone is $6,000-$8,000, and that's for a normal pregnancy. High-risk pregnancies and hospital stays can tack on thousands.

The reports also finds that many health insurance plans don't provide insurance coverage for medical costs related to pregnancy and that insurance companies have plans to reduce the coverage of maternity expenses.

As health insurance companies look for ways to cut costs, denials are up in general. The investigation also found that the four largest insurance companies refused insurance to over 650,000 people due to pre-existing conditions. That's an average of one in seven denied applicants.

In addition, although the number of applicants grew by 16 percent, the number of people denied coverage increased by 49 percent. The report shows that the insurance companies actively sought out ways to deny payment of claims for pre-existing conditions.

It's just another reason why healthcare reform and the Affordable Care Act is so necessary. Both coverage denials and exclusions for pre-existing conditions are banned under the new law. Although not effective until January, 2014, insurance companies will no longer be allowed to deny policy enrollment to a woman just because she is pregnant. The Act also prevents insurance companies from charging higher premiums to women who are pregnant.

When insurance companies refuse to cover a woman just because she is pregnant, the outcomes aren't just financial.  The APA estimates that approximately 13 percent of women who become pregnant each year are not insured, often resulting in inadequate prenatal care. Without the Act, health insurance companies would continue to deny pregnant women coverage. Sign this petition telling Congress you support the Affordable Care Act and don't want to see it repealed.

Photo credit: abbybatchelder