Colorado expands maternity coverage
Mary Lou Jay
As of Jan. 1, 2011, the State of Colorado began requiring health insurance plans in the individual market to cover maternity and childbirth costs.
The new law should provide some relief to Colorado women covered by individual health insurance policies rather than by employer-sponsored group health insurance plans. Maternity expenses can be financially overwhelming; a 2007 study by Thompson Healthcare for the March of Dimes found that the average medical costs associated with pregnancy and childbirth totaled more than $8,800.
Under the new law, all new individual health insurance plans sold after Jan. 1, 2011, must include maternity coverage. All policies that renew after that date must include that coverage beginning on the date of renewal, according to the Colorado Division of Insurance.
There was initially some confusion over which policies would be included in the mandate. The Colorado Division of Insurance issued a bulletin in December 2010 stating that only new policies (and not renewing policies) would be required to provide maternity benefits. But after an additional evaluation, the Division issued a new bulletin requiring that the law apply to renewing policies as well.
The law does not require insurers to offer maternity benefits to women who are pregnant when they purchase a new health insurance policy or when they renew an existing one. That prevents women who already are pregnant from waiting to get or renew coverage until they need it. She would, however, be eligible for benefits for another child conceived after the policy inception or renewal date.
Before the maternity coverage mandate was passed, some lawmakers argued against it by saying that it would raise premiums for all — and that it would be unfair for men to pay higher Colorado health insurance premiums for benefits that wouldn’t apply to them. But the Colorado Division of Insurance points out that spreading the risks over a large population is standard practice for insurance — and that women already have been paying for prostate screenings and prostate cancer treatments, which are exclusively male concerns.
In passing mandated maternity coverage, Colorado joins the fairly exclusive group of states with similar mandates. According to Statehealthfacts.org, a Kaiser Family Foundation website, only 12 states required maternity coverage for the individual market as of January 2010. But those who were covered through group plans have had that coverage since the late 1970s, thanks to the Pregnancy Discrimination Act of 1978, which requires employers with more than 15 employees to cover pregnancy and childbirth-related expenses through their health insurance plans, just as they would cover expenses for any other type of short-term disability.