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Advocates Want Pregnant Women To Qualify for Special ACA Enrollment

Advocates Want Pregnant Women To Qualify for Special ACA Enrollment

February 18, 2015 — Some advocacy groups are urging the Obama administration to allow pregnant women to sign up for health coverage through the insurance marketplaces created under the Affordable Care Act (PL 111-148) outside of the normal open enrollment period, Kaiser Health News reports.

Background

Under the ACA, women can enroll in health coverage after giving birth, even if it is not during an open enrollment period. However, advocacy groups have raised concern that requiring women to wait until after giving birth to sign up for coverage could lead them to forgo care or face thousands of dollars in out-of-pocket costs for prenatal care and delivery.

Call for Change

The March of Dimes, Planned Parenthood and Young Invincibles are among the groups calling for pregnant women to be allowed to enroll at any time. According to a report released Wednesday by Young Invincibles, women who lack access to health coverage might be more likely to forgo prenatal care because of costs, which could put them and their fetuses at risk.

Cynthia Pellegrini, March of Dimes' senior vice president, said that about 50% of pregnancies are unintended and that women cannot predict if they will experience pregnancy complications that require additional services. Allowing pregnant women to enroll in coverage would help protect their health and give women with high-risk pregnancies access to certain physicians and hospitals they might need, according to advocates.

Insurance Industry Resists

The health insurance industry argues that allowing women to enroll after they become pregnant could incent them to wait to purchase health coverage.

Clare Krusing, a spokesperson for America's Health Insurance Plans, said, "If you only create incentives for people to enroll when they have a health need, it poses a tremendous risk to the risk pool and affordability for everyone else." According to Krusing, the change would make it harder for insurers to set premium prices because it would be more difficult to predict who will enroll.

HHS declined to comment, KHN reports (Galewitz, Kaiser Health News, 2/18).