Out-of-pocket cost for childbirth increases in US, study shows

on 17 January 2020

A study which looked at private, employer-provided insurance plans for families in the US found that out-of-pocket costs for childbirth has increased, despite reforms under the US Affordable Care Act.

The study, which was published in Health Affairs, looked at insurance claims made by over 650,000 women with employer-provided plans who gave birth in hospital.

The claims covered maternity care before, during and up to three months following childbirth, which were fully adjudicated (paid off by the insurance plan, the patient, or a combination of both).

In 2008 the average out-of-pocket cost for childbirth was $3,069 (£2,536).

In 2015 the average cost increased to $4,569 (£3,507).

Speaking about the increase in cost, Assistant Professor of Obstetrics and Gynaecology at the University of Michigan and Lead Author of the research, Michelle Moniz, said: “$4,500 is not a small amount. Few of my patients have that kind of money readily available for an unexpected healthcare expense.

Moreover, these costs are incurred at a time when patients are already thinking about how they are going to buy a car seat, crib; how they’ll afford childcare costs.”

The Affordable Care Act, which mainly came into effect in 2014, banned insurance plans that did not cover maternity care costs and preventative services for prenatal patients.

There is also evidence to suggest that the Act lowered out-of-pocket costs for lower-income patients by outlawing dishonest insurance or unfair plans.

However, the Act does not stop insurers from shifting costs of services to patients, which means that patients will have to pay more upfront for medical care before their insurers provide cover.

“I worry that the costs we observed might mean that some patients don’t get recommended maternity services, which can lead to adverse birth outcomes for mum and baby.

“Policies that require insurance plans to cover maternity care at ‘first dollar’, without patient cost-sharing, would go a long way towards reducing financial burdens on families. Such policies might make it easier for all women to get recommended maternity services and help ensure that every baby and every family gets off to the best start,” Michelle Moniz.

An abstract about the study can be found here.