Report Showing What Life Was Like for Women Who Needed Maternity Coverage
Rep. Elijah E. Cummings, Ranking Member of the House Committee on Oversight and Government Reform, and Rep. Frank Pallone, Jr., Ranking Member of the House Committee on Energy and Commerce, released a report originally issued in 2010 by Rep. Henry A. Waxman, who served at the time as Chairman of the House Committee on Energy and Commerce, highlighting the difficulty of accessing affordable maternity coverage in the individual market before the Patient Protection and Affordable Care Act (ACA) was passed by Congress and signed into law by President Obama.
“Before the ACA, not only was being a woman considered to be a pre-existing condition, but women who needed maternity coverage were treated like second-class citizens,” said Cummings. “It defies logic that Republicans would want to take us back to the days when maternity coverage was unaffordable, inadequate, and simply unavailable to many women.”
“The ACA made maternity care an essential health benefit that must be covered, but Trumpcare allows states to waive these benefits,” said Pallone. “Yesterday, the Congressional Budget Office concluded that this would take us back to the days where women could face thousands of dollars in out-of-pocket costs for maternity care. We cannot go back; maternity care must be affordable and accessible.”
#BeforeTheACA, insurance companies discriminated against pregnant women, expectant fathers, and those in the process of adopting a child, and many women who were able to get insured could only count on skimpy supplemental maternity coverage at exorbitant costs:
- Pregnancy was treated as a pre-existing condition and resulted in an automatic coverage denial by all four of the country’s largest insurance companies.
- Expectant fathers were routinely denied coverage. One insurer reserved the right to deny coverage for “any male applicant who is expecting a child with any female whether or not she is listed on the application, whether or not they are legally married.”
- Families “in the final process of adopting a child” and women “in the process of becoming a surrogate mother” could be denied coverage without further review of their medical records.
- One company offered no plans with maternity benefits, except as required by law in one state.
- Another company limited maternity benefits to plans with deductibles of more than $5,000.
- Women were often forced to buy expensive insurance policy riders in order to have their maternity benefits covered:
- One company considered imposing a separate $5,000 deductible before covering any pregnancy-related claims.
- Another capped benefit amounts at $6,000 — even if the enrollee’s pregnancy-related claims amounted to thousands of dollars more.
- Insurance companies were reluctant to cover maternity benefits because of “higher prices, lower margins, and loss of market share”:
- One company’s executives complained that “optional maternity coverage has a very unfavorable impact on our bottom line.”
- The Chief Operating Officer of another company’s individual insurance division referred to maternity riders as “a loser.”
- An executive at another company urged modifying the definition of maternity complications “to ensure we are not paying more than what the states require.”
- Insurance companies designed their business plans to dissuade individuals from seeking maternity coverage:
- One insurance company analyst stated: “Competitively, it seems like we need to offer some kind of rider. But actuarially, we don’t want to make it too attractive.”
- Another company warned: “Increased risk is that by offering a maternity rider we would be attractive to potential members who are likely to have children.”
The TrumpCare bill that passed the House on May 4th would take us back to life #BeforeTheACA. This bill would let states waive critical protections that would in turn:
- allow insurance companies to discriminate against pregnant women by charging them much higher rates for coverage;
- raise premiums on plans that offer maternity coverage;
- make maternity care and other Essential Health Benefits purely optional;
- force women to pay premiums of $1,000 or more per month for maternity coverage under policy riders, according to the Congressional Budget Office; and
- open the door for insurance companies to impose annual and lifetime limits on maternity care and other services in states that do away with Essential Health Benefits.
Ranking Members Cummings and Pallone previously released a report detailing what life was like for people with pre-existing conditions #BeforeTheACA. Cummings also released a video on life #BeforeTheACA.