One of the most expensive parts of having a baby may involve the birth itself, says a new study conducted by researchers at the Michigan Medicine. For some families, average out-of-pocket health care spending for maternity care - including the pregnancy, delivery and three months postpartum - went up from $3,069 in 2008 to $4,569 in 2015, said the report.
Published in the January issue of Health Affairs, the report said under the Affordable Care Act (ACA), which required large, employer-based health plans (used by about 50% of women in the US) to cover maternity care, hasn't protected families. While the ACA requires full coverage of preventive services, such as pap smears and mammograms, there are few restrictions on how plans impose co-pays, deductibles and cost-sharing for maternity care, it said.
"We were surprised to learn that the vast majority of women paid for critical health services tied to having a baby," says lead author Michelle Moniz, an obstetrician gynecologist at Michigan Medicine's Von Voigtlander Women's Hospital and researcher with the U-M Institute of Healthcare Policy and Innovation. "These are not small co-pays. The costs are staggering."
The study included a national sample of 657,061 women enrolled in 84,178 employer-sponsored plans who had been hospitalized for childbirth from 2008 to 2015. Researchers analyzed costs for all health care services used before and after delivery that might influence pregnancy outcomes. Ninety-eight percent of women were found to be paying some out-of-pocket costs.
Costs of childbirth
Childbirth is a leading reason for hospitalization among women of reproductive age. Not surprisingly, out-of-pocket costs for cesarean sections were higher, with mean total out-of-pocket spending rising from $3,364 in 2008 to $5,161 in 2015 for C-sections compared to an increase of $2,910 to $,4314 for vaginal births.
Women also seem to be bearing a higher proportion of total costs. Those with vaginal births covered 21% of expenses in 2015 compared to 13% in 2008. Women with C-sections could expect to pay about 15% of costs, up from 10% during the same years.
Maternity care services are vital to ensuring the best possible outcomes for moms and newborns, Moniz says. This is an especially important focus as data over recent years suggests that the U.S. continues to defy global trends as one of the only developed countries with a rising maternal mortality rate.
"The increasing maternal health costs burdening families over time is concerning. Research tells us that out-of-pocket costs for healthcare are often associated with skipped care," Moniz says, stressing the fact that the financial burden often put women at risk of delaying or missing maternity care.
