Health Insurance and You!

Before health reform, most of the people who got health insurance coverage through their parents were children and teens, with those numbers falling through the college years and tapering off as dependent coverage policies ended for people in their early twenties. The 2010 law changed all that, through a popular provision that allowed young adults to stay on their parents’ plans up to age 26. Hundreds of thousands of young adults have taken advantage of the new rule.

Along with this expansion of coverage came an expansion of the health issues that dependent coverage would begin to address, now that a new age group had been added into the mix. Among those issues was pregnancy. According to an article in the Washington Post by Michelle Andrews, the Pregnancy Discrimination Act of 1978 required most employer-sponsored health plans to cover maternity care for employees and their spouses, but not for other dependents – including young adult children. Some plans do cover maternity care for dependents, but since they are not required to, most do not.

Ms. Andrews cites recent data from the March of Dimes, which estimates the average cost of a pregnancy and delivery without complications at $10,652. Those costs can be significantly higher for teenage moms, who are more likely to have delayed prenatal care and to have smoked, and whose babies are more likely to have a low birthweight. Plus, the medical effects and costs associated with these factors can last well beyond infancy.

Readers, should maternity care be considered an essential health benefit for dependents? The law’s take on this question is unclear; while individual and small-group market insurance plans will have to offer maternity care from 2014 onwards, large-group plans will be exempt from this rule for the foreseeable future.