One of the more popular aspects of the Affordable Care Act allows parents to cover their children under their health insurance plans until they reach age 26, but one thing that that aspect of the bill fails to do is to ensure that their parents’ plan will cover their daughter’s pregnancies.
Group health plans with 15 or more workers are required to provide maternity benefits for employees and their spouses under the Pregnancy Discrimination Act of 1978, but other dependents of employees aren’t covered by the law, so companies don’t have to provide maternity coverage for them.
There is no data on how many companies fail to provide dependent maternity benefits but Dania Palanker, a senior health policy adviser at the National Women’s Law Center says it’s common and that the number may grow with the expansion of coverage to children up to age 26.
According to Dan Priga, roughly 70 percent of companies that pay their employees’ health-care costs choose not to provide dependent maternity benefits. Priga, is the head of the performance audit group for Mercer, a human resources consulting company.
In some states, pregnant woman may qualify for Medicaid, the federal-state health-care program, but eligibility is based on household income and mainly reserved for low income individuals.
According to the March of Dimes, the average cost for uncomplicated maternity care was $10,652 in 2007. That includes prenatal care, a routine delivery and three months postpartum care.
Under the health insurance overhaul, preventive health benefits that are recommended by the U.S. Preventive Services Task Force, a federal agency, must be covered by new plans and by plans that have changed enough to lose their status of being grandfathered under the law. The recommended services include a range of screenings for pregnant women.
Starting in 2014, maternity and newborn care is one of 10 essential health benefits that must be offered by all health plans in the individual, small-group market and state-based health insurance exchanges.
Large-group plans, however, are exempt from the requirement to provide the essential health benefits, now or in 2014.