Gaps In Maternity Coverage For Some Women Could Grow Under Health Law

There's been a lot of controversy over the health care overhaul's requirement that most health plans this month to start covering contraceptive services for women as a free preventive benefit.

But that requirement may prevent some young women from falling into a coverage gap of a different kind: no maternity coverage.

Individual health insurance policies have long been criticized by women's health advocates for their frequent failure to cover maternity benefits for women. According to a recent report by the National Women's Law Center, only 12 percent of plans in the individual market provide maternity coverage.

But group plans aren't necessarily any better. Although the Pregnancy Discrimination Act of 1978 requires health plans to provide maternity coverage to employees and their spouses at companies with 15 or more workers, it doesn't require such coverage for other dependents such as adult children.

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Under the health care overhaul, children can stay on their parents' plans until they reach age 26 under many circumstances, including if they're married, living on their own and financially independent. The expanded coverage window means that more of them will likely become pregnant while on mom and dad's plan, say women's health experts.

Starting in 2014, the law will require coverage of 10 "essential health benefits" in individual and small group plans. Maternity and newborn care is one of them.

But in a surprising twist, since health benefits at large companies are typically more comprehensive than those at small companies or individual plans, large group plans don't have to provide the essential health benefits.

Women's health advocates hope that the law's coverage requirements will encourage those companies to step up to the plate and provide dependent maternity benefits anyway.

"We would expect fewer employers to not cover maternity coverage for dependents," says Dania Palanker, senior health policy adviser at the National Women's Law Center. "They wouldn't want to offer less than the essential health benefits."

Copyright 2023 Kaiser Health News. To see more, visit Kaiser Health News.