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California expands health insurance coverage for maternity care Posted: July 5th, 2012

By Barbara Marquand

California women who buy individual health insurance or get health insurance through their jobs will have coverage for maternity care, thanks to two new laws that took effect July 1 in the Golden State.

Under the new state laws, health insurance plans -- both individual and group plans -- must provide maternity coverage. The requirements put California ahead of many other states in expanding coverage to pregnant women. Nationwide all basic health plans sold through state health insurance exchanges must cover maternity care starting in 2014, under the federal Patient Protection and Affordable Care Act.

Proponents say the new California laws will save money by decreasing the burden on state programs to provide maternity coverage. The coverage expansion could also reduce premature births due to inadequate prenatal care.

The federal Pregnancy Discrimination Act of 1978 already requires employer-sponsored health plans to cover maternity expenses just as they cover other medical conditions. However, the landmark law does not apply to companies with fewer than 15 workers, nor does it apply to individual health plans. Unless a state acts, insurance companies can sell individual health plans and tiny-employer group plans that exclude coverage for maternity care.

According to a 2009 study by the National Women's Law Center, 87 percent of individual health plans available to a 30-year-old woman across the country did not provide maternity coverage.

In California, the percentage of individual plans offering maternity coverage dropped precipitously in the last several years. Eight years ago, more than 80 percent of individual health plans included maternity coverage. Recently, before the new laws went into effect, less than 15 percent of the products sold on the individual market in California included maternity coverage, according to Health Access California, a consumer advocacy group. In some counties, the only individual health plan with maternity coverage available was one with a $5,000 deductible.

The new maternity coverage laws in California are the result of an eight-year legislative effort. Insurance companies resisted the change, but some dropped their opposition after passage of the Affordable Care Act because the federal law will require maternity care coverage in 2014 anyway.

California Insurance Commissioner Dave Jones and consumer groups hailed the new state laws.

"Like other consumer protections and essential benefit standards under the Affordable Care Act that we need to adopt, this helps provide peace of mind for families, so they no longer have to fear the fine print," Health Acccess California Executive Director Anthony Wright said in a press statement.