Maternity Care

State and federal anti-discrimination protections ensure that most employer-sponsored health insurance covers maternity expenses. 1 However, it is very difficult—and sometimes impossible—for women to find coverage for maternity care in the individual health insurance market, where women buy coverage directly from insurers. In a study of the availability of maternity coverage in the individual market, the National Women’s Law Center found that the vast majority (87%) of individual health plans available to a 30-year-old woman across the country did not provide maternity coverage. 2

Footnotes:

1 Pub. L. No. 95-555, 92 Stat. 2076 (1978). The Pregnancy Discrimination Act of 1978 amended Title VII to specify that discrimination on the basis of pregnancy, childbirth, or related medical conditions constitutes unlawful sex discrimination under Title VII.

2 Brigette Courtot and Julia Kaye, National Women’s Law Center, Still Nowhere to Turn: Insurance Companies Treat Women Like a Pre-Existing Condition. October 2009, available at http://www.nwlc.org/resource/still-nowhere-turn-insurance-companies-trea. . accessed September 21, 2010.

3 Colorado's requirement for maternity coverage in the indvidiual market takes effect January 1, 2011. Though Colorado has a maternity coverage mandate for the group insurance market, the law exempts businesses with fewer than 15 employees and therefore does not expand upon the requirements of the federal Pregnancy Discrimination Act. For this reason, the state does not recieve credit for its group market maternity mandate.

4 In New Jersey, limited benefit "Basic and Essential" health plans are exempt from covering prenatal care but must cover costs associated with labor and delivery.

5 In New York, managed care organizations and nonprofit health insurers are required to cover maternity care in the individual market.

6 In Washington, limited benefit "catastrophic" health plans are exempt from the maternity mandate law.