Title: Blessed events and the bottom line: financing maternity care in the United States.

POPLINE Document Number: 046647

Corporate Author(s):

Alan Guttmacher Institute [AGI]

Source citation:

New York, New York, AGI, 1987. 60 p.

Abstract:

Payment for prenatal and obstetric care in the U.S. is presented in all its detail: demographics, sources, implications, including tables, graphs and illustrations. In the U.S., maternity care is financed by a mix of private insurance, government insurance, out-of-pocket and charitable sources. The typical pregnant woman has a family income of $20,000. Pregnancy expenses account for 20% of a year's income on average. Families having babies are more likely to be young, just starting careers, or employed in low paid, service or part-time work. 27% of hospital admissions are for delivery, yet the continuing, preventive care needed for maternity care is not the aim of most crisis-oriented health insurance plans. Increasingly, employment-linked plans are requiring co-payments and larger deductibles or do not cover maternity. Government coverage includes CHAMPAS insurance for civilian dependents of military, or 1 million women, and Medicaid insurance primarily for persons on welfare, including 4 million women. 60% of privately insured couples must contribute toward maternity expenses. 26% of women of reproductive age have no maternity coverage; many become eligible for Medicaid when they become pregnant, leaving 15% uninsured. 550,000 women deliver each year at public expense. These women are likely to be poor, black, teenage or unmarried, and also more likely to have had little or no prenatal care. While 37% of births overall are unplanned, the percentage rises to 55% of blacks, 62% of those on Medicaid, 73% of the never-married and 79% of teenagers. 27% of hospital admissions of persons of reproductive age are for delivery. The high cost of insurance is abetted by availability of expensive high technology to save high risk infants of those who do not attend prenatal care because they cannot afford insurance or care, as well as malpractice costs in obstetrics. Suggested recommendations are primarily variations on legislation to fund prenatal care for all who need it, to remove stigma felt by Medicaid recipients, to coordinate existing programs or provide a system of consistent prenatal, obstetric and infant care nationally. All these expenses are already being paid by someone, even if by charity or higher hospital costs and insurance premiums: the only new expense would be relatively inexpensive early prenatal care.

Keywords:

United States
North America
Economics
Social Planning
Health and Welfare Planning
Financial Activities
Financing, Government
Medical Assistance, Title 19
Community Financing
Health Insurance
Maternity Benefits
Reproductive Behavior
Pregnancy
Pregnancy, Unplanned
Adolescents
Ethnic Groups
Blacks
High Risk Women
Parents
Mothers
Childbirth
Delivery of Health Care
Health Services
Medicine
Maternal Health Services
Antenatal Care
Government Programs
Privately Sponsored Programs
Adolescent Pregnancy
Developed Countries
Americas
Social Sciences
Economic Factors
Public Assistance
Microeconomic Factors
Fertility
Population Dynamics
Demographic Factors
Population
Reproduction
Youth
Age Factors
Population Characteristics
Cultural Background
Family Relationships
Family Characteristics
Family and Household
Pregnancy Outcomes
Health
Maternal-Child Health Services
Primary Health Care
Programs
Organization and Administration