Before the Affordable Care Act, insurance policies rarely included maternity coverage. Nowadays, people can purchase that sort of coverage during open enrollment. For twenty women’s rights organizations, however, the situation requires more attention: What about unplanned pregnancies?
While ACA insurance policies cover what happens after childbirth, there’s little in place for women who are currently pregnant—particularly if they didn’t plan to be.
Currently, the ACA allows women to sign up for coverage during the open enrollment period. It also allows for “special enrollment periods” due to major life changes—losing a job, for example. Lobbyists are hoping to add pregnancy to that list so that more women are able to use the ACA to get the care they need.
“We’re not talking about women who are gaming the system and waiting to sign up for coverage until they need it,” said Christina Postolowski, health policy director for Young Invincibles. “We’re talking about women [who] might not be planning on becoming pregnant.”
Women who can’t afford prenatal care and have no insurance are likely to fall victim to issues that affect both the mother and the unborn child, such as diabetes and high blood pressure. The potential trade-off, of course, would be more costly premiums for the insured. If a woman could sign up for coverage right before a costly life change, those who already have coverage would likely have to pay more. It could also cause problems for the insurance companies.
“The reason why it’s critical to have defined open enrollment periods is so health plans can accurately develop their rates for the upcoming year,” said Clare Krusing, communications director for the industry trade group America’s Health Insurance Plans. If women could enroll at any time, it would be more difficult for insurance companies to determine rates.
If the change in policy does occur, it would only apply to plans purchased on Healthcare.gov. States running their own insurance marketplaces would have to decide on an individual basis whether or not to offer the special enrollment on their policies.