MATERNITY CARE A MUST IN HEALTH PLANS WITH NEW LAW

By John Barrett (Based on a story appearing in the San Francisco Chronicle)

In an effort to help improve the health of mothers and infants in California, Gov. Jerry Brown has signed into law a measure that will prevent health insurers from excluding maternity care as a covered benefit.

The new law will require individual insurance policies, beginning July 1, 2012, to cover maternity just as any other condition that requires medical services.

Insurance companies began eliminating maternity coverage from individual policies to mitigate rising health care costs and insurance premiums. The move to less-expensive policies left Californians either unable to find or afford policies that did cover maternity services, or struggling to pay for pre- and post-natal care.

Current law requires health maintenance organizations, HMOs, and health insurers to include maternity coverage in their group plans. But that’s not the case for individual policies, which are typically bought by people who do not have access to group coverage through their work.

In 2010, just 12 percent of individual policies offered maternity coverage, a steep drop from 82 percent seven years ago. With so few options available, the policies that include maternity tend to be pricey because insurers figure the people willing to buy the plan are likely to use it.

The new law is expected to increase premiums for individual policyholders by an average of $6.92 per month, according to the bill’s analysis (I consider this a very low estimate). Insurers will be required to cover the full scope of maternity services, but with the same cost-sharing or co-payments required for other medical services under the policy.

In the past, several insurers opposed the bill, but the federal health care law may make maternity coverage inevitable. Maternity and newborn care are among the benefits expected to be required in plans as of 2014, when most Americans will have to buy insurance.

“There’s really no point in opposing this,” said Richard Wiebe, spokesman for the Association of California Life & Health Insurance Companies, which dropped its opposition to the bill.

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