Many Calif. Women Face Challenges in Obtaining Maternity Care Benefits

California law does not require health insurers to provide maternity benefits to those who purchase coverage in the individual market, leaving many women struggling to obtain maternity services, the Los Angeles Times reports.

Limited Options

Out of the 295,000 California women of childbearing age who purchase individual insurance policies, 81% lack maternity coverage.

Health experts say many women cannot afford the benefits because individual policyholders pay about 20% more on average for plans that cover maternity care. The average cost of delivering an infant in California is nearly $13,000.

In addition, women who apply for individual insurance policies after becoming pregnant often are turned down by insurers that regard pregnancy as a preexisting condition.

The lack of options leads many women of childbearing age to enroll in government-run insurance programs or bypass prenatal care services that sometimes can prevent expensive medical complications. This increases costs for hospitals, insurers and consumers who purchase individual policies.

Resistance to Proposed Legislation

California lawmakers have introduced numerous bills that would have required health plans to cover maternity services, but such legislation has faced resistance from the insurance industry.

The Association of California Life and Health Insurance Companies said a study found that a recent maternity coverage bill would increase premiums by as much as 28%.

In addition, Anthem Blue Cross has argued that it is unfair to expect all consumers to pay for maternity benefits if they do not need or want them.

Over a six-year time period, Gov. Arnold Schwarzenegger (R) has vetoed four bills designed to expand maternity coverage.

Support for Expanded Benefits

Blue Shield of California and Kaiser Permanente have supported legislative efforts to improve maternity coverage, noting that requiring the benefits in all plans could reduce costs for individuals who need the services.

Meanwhile, women's health advocates are looking ahead to 2014, when the federal health reform law will require insurers to include maternity services in all health plans sold to individuals and small businesses (Helfand, Los Angeles Times, 12/12).