Washington, D.C., June 12, 2007: For women insured through large employer private plans, the average cost of having a baby in the United States in 2004 was more than $8,000, a study released today by the March of Dimes Foundation revealed. The study, "The Healthcare Costs of Having a Baby," was commissioned by the Foundation to estimate expenditures for maternity care by large employer private plans and was conducted by Thomson Healthcare.
"This in-depth analysis of health claims from more than 10 million employees, spouses and dependents is an important contribution and demonstrates the value of access to comprehensive, affordable health insurance for women of childbearing age. Having a baby is the most costly health event families are likely to experience during their childbearing years and health insurance is central to obtaining maternity care services critical to the health of the woman and that of her newborn. An uninsured healthy pregnancy can be a financial strain on young families, and a catastrophe in the case of a high-risk birth," said Dr. Jennifer L. Howse, president of the March of Dimes.
In its analysis, Thomson combined the costs of prenatal care, labor and delivery as well as post-partum care provided during the three months following delivery and found that employer based insurance covered approximately 95 percent of the costs of maternity care.
Significant findings include:
- Average expenditures for maternity care were $7,737 for vaginal delivery, of which about $7,205 was paid by private health plans and $463 in out of pocket costs was paid by the family..
- Average expenditures for maternity care were $10,958 for cesarean-section delivery, of which about $10,324 was paid by private health plans and $523 in out-of-pocket costs paid by the family.
- Vaginal delivery costs were distributed in the following way: 48% facility fees; 36% professional service fees; 8% radiology and imaging; 5% outpatient drug; and 4% laboratory.
- Cesarean-section delivery costs were distributed in the following way: 53% facility fees; 32% professional service fees; 7% radiology and imaging; 4% outpatient drug; and 3% laboratory.
- It is most expensive to have a baby in the northeast, least expensive in the south and the same pattern holds for cesarean-section & vaginal deliveries. Average expenditures for vaginal delivery by geographical region were $8,718 in the northeast, $7,455 in the south, $7,501 in the north central, and $7,880 in the west.
- Average expenditures for cesarean-section delivery were $12,175 in the northeast, $10,317 in the south, $10,969 in the north central, and $11,581 in the west.
"While most women obtain their health coverage through private, employer sponsored plans, more than 40 percent of women rely on publicly financed programs including Medicaid and the State Children's Health Insurance Program (SCHIP) for their maternity coverage. However, enrolling income eligible women age 19 and older in SCHIP requires a federal waiver, an unnecessarily cumbersome administrative step that states must take. Because we at the March of Dimes believe every woman and her infant should have health insurance we are working with a broad bipartisan group of Members of Congress to add a provision to the SCHIP reauthorization bill that will give states the option to enroll income eligible pregnant women in the program without having to obtain a waiver." said Dr. Howse.
Another study, released by the Henry J. Kaiser Family Foundation at a joint briefing with the March of Dimes today, found that, unlike well-child care or mammography, prenatal care was generally not considered a preventive service in the plans reviewed by the researchers. As a result, these consumer directed health plans impose cost sharing and high deductibles on prenatal care services.
"It is well documented that lack of adequate, regular prenatal care is associated with poor birth outcomes, including prematurity and low birthweight and such out of pocket expenditures for cost sharing may well discourage women from obtaining the care they need to prevent these and other high risk and costly conditions. The study finding is troubling and signals the need for additional research to determine whether the practice of excluding prenatal care from the list of preventive benefits is widespread among consumer directed health plans." Dr. Howse continued.
Both studies were released at a policy forum in Washington, D.C. that included Dr. Howse; Diane Rowland, ScD, Kaiser Family Foundation executive vice president, Alina Salganicoff, PhD, Kaiser Family Foundation vice president and director of Women's Health Policy; Stella Chang, Associate Director for MarketScan, Thomson Healthcare; Karen Pollitz, project director at the Georgetown Health Policy Institute; Tom Wilder, Senior Regulatory Counsel at America's Health Insurance Plans; and Lisa Potetz, principal at Health Policy Alternatives, Inc.
Materials from the forum, including a webcast, will be available at http://www.kaisernetwork.org/healthcast/kff/12jun07.
The March of Dimes is a national voluntary health agency whose mission is to improve the health of babies by preventing birth defects, premature birth, and infant mortality. Founded in 1938, the March of Dimes funds programs of research, community services, education, and advocacy to save babies and in 2003 launched a campaign to address the increasing rate of premature birth. For more information, visit the March of Dimes Web site at marchofdimes.org or its Spanish language Web site at nacersano.org.