Having a Baby May Cost Some Families $4,500 Out-Of-Pocket

Despite an ACA mandate that large, employer-based health plans cover maternity care, some are shouldering more of the expenses tied to having a baby.

4:00 PM

Author | Beata Mostafavi

Baby carriage image

 

One of the most expensive parts of having a baby may involve the birth itself, a new Michigan Medicine study suggests.

For some families, average out-of-pocket health care spending for maternity care – including the pregnancy, delivery and three months postpartum – jumped from $3,069 in 2008 to $4,569 in 2015, according to findings published in the January issue of Health Affairs.

And the Affordable Care Act (ACA), which required large, employer-based health plans (used by about 50% of women in the U.S.) to cover maternity care, hasn't protected families from shouldering a big brunt of costs.

LISTEN UP: Add the new Michigan Medicine News Break to your Alexa-enabled device, or subscribe to our daily updates on iTunes, Google Play and Stitcher

The reason: 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.

"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, M.D.,M.Sc., 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 $4,314 for vaginal births.

These financial burdens put women at risk of delaying or missing maternity care, which we know can lead to poor maternal and birth outcomes.
Michelle Moniz, M.D.,M.Sc.

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.

MORE FROM MICHIGAN: Sign up for our weekly newsletter

"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.

"These financial burdens put women at risk of delaying or missing maternity care, which we know can lead to poor outcomes for women and babies. Restricting patient spending for maternity care may be an important opportunity to improve maternal and neonatal health for American families."

Higher deductible plans and co-pays, along with possible misconceptions about what the ACA requires for maternity health care coverage, may be areas advocates and lawmakers could target for improvement, Moniz says.

"There is strong rationale for policymakers to consider policies to protect the average consumer," Moniz says.

"Maternity and childbirth care are essential health services that promote the well-being of families across our country. Reducing patients' costs for these high-value services makes sense. We all want babies to have the best possible start in life."


More Articles About: Rounds Gynecology childbirth High-Risk Pregnancy Caesarean Section Womens Health Von Voigtlander Women's Hospital Community Health Health Care Delivery, Policy and Economics obstetrics
Health Lab word mark overlaying blue cells
Health Lab

Explore a variety of healthcare news & stories by visiting the Health Lab home page for more articles.

Media Contact Public Relations

Department of Communication at Michigan Medicine

[email protected]

734-764-2220

Stay Informed

Want top health & research news weekly? Sign up for Health Lab’s newsletters today!

Subscribe
Featured News & Stories Older couple holding hands
Health Lab
In sickness and in health, older couples mostly make Medicare moves together
A new study suggests the need for more efforts to help both members of a couple weigh and choose their Medicare options together, because most changes of plan occur with both members of the couple changing from the same option to the same option.
Speculum illustration including a gloved hand holding a swab in front of microscopic cells
Health Lab
U.S. could cut cervical cancer cases, deaths by up to 20% if more patients followed up after screening, study suggests
Many women don’t get cervical cancer screening such as Pap tests, or don’t go for follow up diagnostic tests; a new study shows what could happen if all of them did.
gun with lock on it with key there gun is in black and background yellow and lock is white
Health Lab
Michigan’s new firearm injury prevention laws: What everyone should know
Michigan has a set of new laws related to firearms, all designed to reduce the risk of injury and death across the state.
Spilled pills next to a stethoscope and pile of cash
Health Lab
Drug pricing program improved prostate cancer treatment adherence
Socially vulnerable patients were more likely to stick with oral medications when treated at a hospital participating in 340B program, suggesting these hospitals may have more resources to help patients.
Health Lab
Fitness instructor, backpacker returns to active lifestyle after years of pain from endometriosis
Woman seeks answers for painful periods, leading to the discovery of endometriosis, large ovarian cysts, organ inflammation and appendix cancer
computer
Health Lab
Same patient. Different visit. Different race and ethnicity?
Data on the race and ethnicity of patients underpins efforts to reduce health care disparities, but a study shows inconsistent recording in emergency departments