Celebrating Health Reform

I am posting this today in celebration of the one year anniversary of the Affordable Care Act as part of the National Woman's Law Center and MomsRising Blog-aThon. 

Way back, even before we really started trying to get pregnant, I decided to find a local obgyn who I could start building a relationship with so that, when the time came, I would have a dr for my pregnancy. Little did I know that years later I'd still be trying, but that is besides the point of this story. 

Back in 2007 I was a successful small business owner running an industrial fruit brokerage business. My husband was busy working as a self-employed architect. We have always taken a lot of pride in being financially responsible, built a solid emergency fund, set up and made regular contributions to our retirement accounts, and each carried a high-deductible individual health insurance policy. We live frugally, but very comfortably and had made conscious decisions to build flexibility into our careers that would allow us to support our future family. 

We'd talked about starting a family, so I checked my health insurance plan to see which doctors were covered. You can imagine my surprise when I learned that my health insurance plan did not include any OB-GYN in the county where I live. The real shock set in when my insurance broker explained that the rules for individual plans were different from group health plans and that as a result almost all (98%) of the individual plans offered in my County excluded maternity coverage. 

As my broker reviewed the options availalbe for a plan that would include maternity coverage, it quickly became clear that the risk pool for these plans was limited to women who intended to become pregnant. The monthly premiums were over 5 times the amount my husband was paying and the deductibles approached $15,000 compared to the $3,500 deductable on my husbands plan. I could recall that we'd switched my husband to a non-maternity plan a year earlier in order to save a few dollars per month on his premium. 

I felt that my anatomy made me an expensive liability that was going to drain our hard earned savings and saddle our family with medical debt.  I felt like a second-class citizen at the mercy of decision makers who didn't care about my health, dreams or goals.  The more I learned, the more disheartened I felt with the whole system.

For us, the issue of maternity coverage has been resolved thanks to a new job I accepted in 2009 - with a large employer who offers an excellent group insurance plan. Ironically this new job will provide me with the maternity coverage I need to start a family, while ultimately preventing me from maintaining the work-life balance that will allow me to raise my future children. I will always be proud of the success I achieved as a small business owner. 

Considering that an estimated 50% of pregnancies are unplanned, and that no form of birth control is 100% effective, it is simply irresponsible for any woman of child-bearing age to carry health insurance that does not include maternity coverage.  

I testified before the California Assembly Health Committee in 2009 because the rules governing the Individual Health Insurance market, specifically as they relate to the exclusion of maternity coverage, prevent young couples like my husband and I, from being able to start a family without the threat of financial ruin or dependence on state subsidized programs. 

Over 60% of the births in my County are paid for by Medi-cal or other state subsidized programs. I urged our legislature pass legislation that would allow women to take responsibility for their own health care.

Without this legislation and without access to comprehensive individual health insurance that includes maternity, women will face growing challenges providing for their own basic health needs. The current system makes it exceptionally hard for women to take responsibility for their own health care, a necessary pursue their dreams as self-employed entrepreneurs and stay at home mothers.

So many of us lament the exclusion of infertility benefits from our health insurance plans, and that is something that we need to start speaking up about, but to think that we live in a society that doesn't value women and families enough to ensure that woman can purchase their own health insurance with assurance that it will cover their most basic health needs, well that just makes me sick.

California Senate Bill 155 has just been introduced to require individual insurance plans in California to include basic maternity coverage. Yeah, you read what I wrote correctly. Most individual insurance plans in California exclude coverage for basic maternity.  In fact most individual insurance plans across the country exclude maternity coverage, except in those states where is is mandated. Somewhere along the way, maternity coverage became classified as an extra, an unnecessary expense, and thousands of young women were left holding the bag.

Our new Insurance Commissioner Dave Jones came out early in support of SB 155 and even though similar legislation was vetoed by our previous Governor four years in a row, we have every reason to believe that our new governor Jerry Brown will sign the Bill this year. 

This is just one of the reasons that I fought so hard for the passage of the The Affordable Care Act. Come 2014, when this provision of the ACA becomes law, all women in all states will be guaranteed maternity coverage as a fundamental part of their health insurance.

Until then, we are on our own. I actually spent a good portion of this past weekend trying to figure out how to get maternity insurance coverage for a good friend who is ready to start her family. Our conclusion was that without state or federal legislation like SB155 or the ACA, she is out of luck.  


EDITED: For a complete list of posts celebrating Health Care Reform:
http://www.nwlc.org/our-blog/affordable-care-act-and-womens-health-blog-thon-–-posts

(Don't forget that every comment during my ivf cycle is an entry into my giveaway! Thank you!)