The Affordable Care Act is the first health care legislation that explicitly forbids gender discrimination in insurance coverage. In fact, Section 1557 of the ACA prohibits discrimination against anyone based on their gender, race, color, national origin, disability, age and gender identity. This means that women will receive comprehensive coverage for all facets of their life, including maternity care, right? Not necessarily.
Early last week, the National Women’s Law Center filed complaints against five large, publicly funded employers for not extending their maternity coverage to dependents of employees. Considering that now, children of insured employees can stay on their parents’ insurance plans until they turn 26, and since we are now seeing a rise in teen pregnancy rates, young women who become pregnant need insurance for their maternity care, but a loophole in their coverage policy doesn’t require maternity benefits to be extended to dependents of the insured. It is generally required for maternity benefits to be offered to spouses of insured employees, but not their dependants.
According to Judy Waxman, the National Women’s Law Center’s Vice-President for Health and Reproductive Rights,
When an institution excludes maternity coverage for the female dependent children of its employees, it means that young women on their parents’ plans receive benefits that are less comprehensive than those provided to young adult men… Providing a less favorable set of benefits to employees’ daughters compared to their sons is not only unfair, it is also discrimination on the basis of sex – a violation of Section 1557 of the ACA.
From prenatal through post-pregnancy care, an uncomplicated pregnancy can cost upwards of $10,000, which is no small cost to an expectant mother who is worried about buying formula and diapers for her newborn child. Even with insurance coverage, it’s sometimes the case that expectant mothers dish out money for co-pays each time they visit the doctor. Women are often required to see their doctor once or twice a week during the last trimester, so the cost of a pregnancy adds up quickly.
According to the National Women’s Law Center website, the five institutions against which this claim was filed are:
- Battelle Memorial Institute, a research and development organization based in Columbus, Ohio, with over 22,000 employees in more than 100 locations globally, including many across the U.S.
- Beacon Health System, located in South Bend, Indiana, is the parent organization of Elkhart General Hospital and Memorial Hospital of South Bend, which operate in North Central Indiana and Southwestern Michigan. Beacon employs over 3,800 people.
- Auburn University, a public university in Auburn, Alabama with over 4,500 full-time non-student employees.
- Gonzaga University, a private university located in Spokane, Washington with 1,000 faculty and non-faculty employees.
- The Pennsylvania State System of Higher Education (PASSHE), located in Harrisburg, Pennsylvania, is “a public corporation and government instrumentality” consisting of fourteen public universities across the state. PASSHE employs over 12,150 professional and support staff.
However, the problem does not end with these five employers. Some estimates show that, of the firms who “self-insure” for health benefits, 70% don’t provide pregnancy coverage for dependents. Considering that each year, around 3 million women under the age of 25 get pregnant, this insurance loophole is a huge problem. Women should be covered under insurance during their pregnancy no matter what their age, and hopefully Section 1557 of the ACA can ensure that happens.
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