Nearly 20% of maternity care costs now fall on patient, U of Michigan study finds

Morgan Haefner -

Out-of-pocket spending for pregnant women with employer-based health plans is on the rise, largely due to higher deductibles, according to a study published in Health Affairs.

For the study, researchers from the University of Michigan in Ann Arbor evaluated trends in cost-sharing for maternity care from 2008-15. Study authors examined information from the Clinformatics Data Mart Database. The data represented nearly 660,000 women who were hospitalized for birth and who were covered by more than 84,000 private health plans.

The authors found that while the ACA required employers to include maternity services in their health plans, plans could increase copayments and deductibles for the services. Due to these increases, women saw their mean out-of-pocket spending for maternity care climb from $3,069 in 2008 to $4,569 in 2015.

While out-of-pocket spending rose during the seven-year period, the standardized cost of maternity care remained stable. As a result, the average overall share of maternity care costs that patients paid out of pocket climbed from 12.3 percent to 19.6 percent.

"Despite provisions in the ACA and other policies that require maternity coverage, coverage without out-of-pocket spending is not required for most maternity services," the authors concluded. "Out-of-pocket spending for maternity care is rising over time among women with employer-based insurance, most notably among those with deductibles. State and federal policy makers should consider implementing policies to restrict cost sharing for maternity care."

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