Senate Dems: Get Pregnant, Then Get Health Insurance

Women joggingWhile everyone else is wondering whether the Supreme Court will replace Obamacare in 37 states with the actual Affordable Care Act as written, some Democratic U.S. Senators are urging women to dive deeper into Obamacare’s perverse incentives by encouraging them to delay getting health insurance until after they become pregnant.

As reported by Lydia Wheeler in The Hill, Senator Patty Murray has round up 36 signatures on a letter addressed to U.S. Health & Human Services Secretary Sylvia Burwell urging her to pull yet another “special enrollment period” out of her bag of tricks.

In a statement, Christina Postolowski, health policy manager of Young Invincibles, said she’s thrilled to see a growing chorus of leaders calling on the administration to create a special open enrollment period to make maternity coverage available to pregnant women year-round.

According to Postolowski’s December 2014 report “Without Maternity Coverage” maternity care and delivery ranges from $10,000 to $20,000 without complications.

Secretary Burwell has recently conjured up a special enrolment period, in April, for those who are shocked to learn from the IRS that they have to pay a fine (or tax or penalty) for not having Obamacare-qualifying coverage in 2014.

The proposed pregnancy waiver seems discriminatory. Why are women who plan on getting pregnant the only ones to be offered the opportunity to avoid Obamacare until they decide to shift the costs of their pregnancies to insurers and taxpayers? What about people who engage in dangerous sports? Should I not have the ability to delay enrollment until I go on my next SCUBA-diving vacation?

This is an example of adverse selection. It is similar to allowing a driver to purchase automobile insurance after he has started competing in the Dakar long-distance race across the deserts of North Africa. The proposed pregnancy waiver would cause premiums in Obamacare exchanges to increase even higher that they already have.

(In employer-based coverage, there are also special enrollment periods for events like divorce or a spouse losing her job with benefits to which you subscribe. However, these are bad events that people usually want to avoid, so adverse selection is not a consideration.)

Comments (9)

Trackback URL | Comments RSS Feed

  1. Ben Rolfe says:

    “Kids: start smoking, then get health insurance!”

  2. Perry says:

    Have coronary, get health insurance!

  3. Brian A says:

    Since they aren’t covered it is in the unborn child’s best interest for the Mom to have health coverage.. Odd argument – should we instead demand that women not have health insurance during a pregnancy?

    • John R. Graham says:

      No. “we” shouldn’t demand anything. But we should expect that people should act responsibly and get health insurance before starting a family.

      • Eric Potter MD says:

        Agree with John, no demanding, just setting reasonable expectations that people plan ahead instead of expecting everyone else to take care of them. Allow Moms to open enroll, but they should pay a “retro” fee to make up for the time when they were not paying.

        Just think, let’s wait to get a driver’s license until after we start driving and get pulled over speeding. Then let’s wait until we have an accident to buy car insurance.

        Can people not see that this concept is illogical?

  4. Bob Hertz says:

    The vast majority of group plans have covered maternity for years, even if the new mother has just started employment in the firm. The costs of this unpaid-for coverage are absorbed by the group as a whole.

    And it doesn’t kill anybody (although the group plan becomes marginally more expensive.)

    In the individual market before 2010, a potential mother had to buy a special expensive rider on their policy to cover maternity. The costs were not spread amongst other insureds.

    Personally I think that society as a whole should support new mothers and help them avoid hospital debt. Having just returned from a trip to Europe and Israel, I can promise that those nations automatically step in and cover all births with national health insurance. They consider a “social good,” something whose cost we share because it makes the nation a better place. (they also have low birth rates and want to see more children)

    Anyways, there may be a better way to support new mothers besides guaranteed issue, but I wanted to frame the issue.

    • John R. Graham says:

      True, Mr. Hertz, but an obviously pregnant woman is not usually out looking for a job. If she does, let’s face it, she is not going to get one.

      You may also have read articles about how companies go out of their way to avoid hiring new mothers. I have read that the HR department sometimes sends a person out to the visitor parking lot when a candidate comes in for an interview, to peek into the car for evidence of kids, e.g. a car seat.

  5. Bob Hertz says:

    I agree that dropping all the costs of childbirth onto the employers that have group health plans is not ideal.
    I would favor a tiny increase (about one percent) in Social Security taxes to pay for maternity benefits and maybe 12-16 weeks of paid leave for every new parent.
    Every single worker and every single employer would pay this tax. An individual firm would not gain by discriminating against new mothers.
    I keep saying that in some circumstances, social insurance actually works.

    • Eric Potter MD says:

      Rather than offer another 1% of my income in SS tax, should you consider taking some of you money and paying for maternity benefits? Why is it that everyone feels so free in giving away everybody else’s money. We do a Christian health co-op, but pay for one child’s chronic medical costs as it was a pre-existing. We get help from two drug companies, but pay out of pocket and don’t sign up for government help. Why is it so difficult to conceive of a world where people take some responsibility to plan ahead?