Does Making Maternity Care Optional Put the Consumer in Charge? Some Conservatives Think So.

According to the Chicago Tribune:

President Donald Trump’s pick to lead the government’s major health insurance programs says maternity coverage should be optional for patients.

Indiana health care consultant Seema Verma tells the Senate Finance Committee that patients — not the government — should determine the insurance benefits they need.

Verma tells Stabenow that some women want maternity coverage and “some women might not choose that.”

Republicans have criticized the law’s requirement that insurers cover a standard set of “essential” benefits, including women’s health services.

Verma would head the Centers for Medicare and Medicaid Services, which also oversees the 2010 health law.

Does anyone recognize the problem with this statement? Before the ACA, who actually determined what benefits they would receive? I’ll give you a hint: it wasn’t patients.

I remember the first insurance plan I had, after I married. I’m not that old, so this actually wasn’t that long ago. Anyway, the plan’s benefits explanation stated that maternity would only be covered after I had had the insurance for twelve months. If I got pregnant before then, maternity would not be covered.

This was coverage I purchased through my university. Would it have been different if I had purchased insurance on the private market, rather than through a quasi-employer? Not necessarily:

Prior to 2014, women who purchased their own health insurance were often completely out of luck if they wanted to have coverage for maternity. In 2013, the National Women’s Law Center reported that just 12 percent of individual market plans included maternity benefits. …

… maternity coverage in the individual market was extremely rare, and if it did exist, it was generally in the form of an expensive rider that could be added to a plan, usually with a waiting period. Yet even on plans that excluded maternity coverage, women were charged premiums that were at least 30 percent higher than those charged to men for the same coverage.

Before Obamacare made coverage guaranteed issue, pregnancy itself was also considered a pre-existing condition that would prevent an expectant parent — male or female — from obtaining coverage in all but five states. And many individual health insurance carriers considered a previous cesarean section to be a reason to decline an application or charge a higher initial premium.

This is not what putting the consumer in charge looks like.

I remember thinking how ridiculous it was that my insurance company could determine when I would be allowed to have a baby. Okay sure, it’s not quite as extreme as that, but when prenatal care and childbirth costs upwards of ten grand, whether maternity is covered by one’s insurance can’t not have a significant impact on one’s reproductive decisions.

Frankly, anyone who is pro-life really should be pushing for universal maternity coverage. Consider the insurance coverage I had a decade ago. What options would a woman have if she had an unintended pregnancy five months after starting coverage? She could either keep the pregnancy and pay for maternity care out of her pocket, which would set her back close to ten grand even without complications, or she could have an abortion and save that money. Even a woman who wanted kids would have reason to have an abortion and wait to become pregnant again until after maternity was covered.

Let me return, though, to where I started—critics of the ACA often speak of pulling back government regulation of the health insurance industry and putting the consumer back in charge. But who is actually in charge, in the absence of government standards for coverage? The consumer? Or the insurance companies?

I have a Patreon! Please support my writing!