Legislation would permit pregnant women to obtain insurance year round

Stringer: Pregnant at the ‘wrong time?’

March 23, 2015 By Mary Frost Brooklyn Daily Eagle

Officials are working on state legislation that would treat pregnancy as a “qualifying event” for insurance under the Affordable Care Act. AP photo/KTLA

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February 15 marked the close of the open enrollment period for health insurance. This means big trouble for uninsured women who have just discovered that they’re pregnant.

Though it may seem like a no-brainer, pregnancy is not defined as a “qualifying event” to obtain health insurance outside of the open enrollment period.

Officials including NYC Comptroller Scott Stringer, Sen. Liz Krueger (D-Manhattan) and Assemblymember Aravella Simotas (D-Queens) point out that this policy costs more money and trouble than it saves, and are working on state legislation to change it.

The legislation would treat pregnancy as a “qualifying event” for insurance under the Affordable Care Act.

Stringer, who has written to the state Department of Health requesting a regulatory change, released a report on Thursday describing the dilemma faced by pregnant women who find they’ve missed the official timetable. Prenatal healthcare can cost upwards of $20,000 out of pocket, leading some women to simply skip it.

“Expectant mothers shouldn’t have to choose between seeking prenatal care and paying the rent, yet this is the choice the Affordable Care Act (ACA) is placing upon women who become pregnant at the wrong time,” Stringer said in a statement. “This isn’t a women’s issue — -it’s a societal issue in which all of us have a stake.”

“The failure of the ACA to recognize pregnancy as a qualifying event for accessing health coverage outside of special enrollment periods is a glaring error that must be remedied,” Krueger said in a statement.

Assemblymember Simotas called the legislation a “common sense legislative fix.”

According to Stringer’s report, every $1 of counseling and nutrition advice provided to pregnant women can save between $1.77 and $3.33 in medical care in the first 60 days after birth.

Babies born to women who receive no prenatal care have an infant mortality rate five times that of women who received recommended care, and are three times more likely to be born at low birth weight, requiring hospitalization and neo-natal intensive care.

The non-profit group Young Invincibles (YI) in February issued a study on the issue of prenatal care. Besides pointing out the benefits of allowing pregnant women to enroll in insurance year round, YI also looked at why insurers might not want to allow it.

Insurers worry that allowing anytime enrollment could “incentivize women to wait to sign up for health insurance until they become pregnant,” YI explains. This is known as “adverse selection,” offering a bad return on investment for insurance companies and increased costs for the pool of insured individuals.

YI maintains the concerns are overblown, however, chiefly because of a “decreasing number of women without insurance, and the decreasing number of plans that do not offer maternity coverage.

“This significantly reduces concerns about risk pool destabilization and premium increases,” the group says. By 2019, health care reform could further reduce the number of uninsured individuals by tens of millions, they add.

Other advocacy groups, including A Better Balance and the New York Civil Liberties Union, have backed the legislation.

Stringer’s report is titled: “Time to Deliver: Pregnancy and the Affordable Care Act.”