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What expectant mothers should know about health reform Posted: December 5th, 2010

By Meredith Ledford

Did you know that 85 percent of women have given birth by the time they reach 44 years of age? Although childbirth is a commonplace event, the support services for mothers and babies were not covered by many health insurance policies.

On March 23, 2010, President Barack Obama signed into law the Patient Protection and Affordable Care Act (i.e. health reform) giving pregnant women and mothers greater access to health insurance and therefore, health care services.

Below are some of the key provisions, according to the National Women's Law Center and HealthCare.gov, under health reform that may benefit expectant mothers.

Changes to health insurance and health care services in 2010

Following are changes, under health care reform, which go into effect in 2010:

  • Medicaid, family planning services and birth centers. Family planning services must be included in all Medicaid benchmark plans, and states have the option to expand Medicaid coverage for family planning services to the income eligibility level for pregnancy. Additionally, Medicaid must cover services provided by freestanding birth centers.
  • Facilities to express breast milk. Employers must provide breaks and a private place (i.e. not the bathroom) for nursing mothers to express breast milk.
  • Health insurance and cost-sharing reforms. The health insurance practice of implementing lifetime limits on coverage is prohibited. New health insurance plans, without the use of referrals, must allow direct access to OB/GYNs. Additionally, new health insurance plans must cover preventive health care and screening services without cost-sharing requirements.
  • Maternity coverage: Medical insurance companies cannot drop your coverage if you get pregnant just because you made a mistake on your coverage application.
  • Health insurance for your child: Employer-provided health insurance and new individual medical insurance policies cannot deny or exclude coverage for your baby (or any child under age 19) because of a pre-existing condition, including babies born with health problems.
  • Tobacco cessation services. In October 2010, Medicaid must cover tobacco cessation services for pregnant women, free of charge.

Additional changes under health reform

In addition to the health insurance and health care provisions that benefit pregnant women in 2010, the Affordable Care Act also requires reimbursement for certain services and provides funding for several programs.

  • Reimbursement for certified nurse midwives. Beginning in 2011, certified nurse midwives receive equitable reimbursements under Medicare and are paid at an equal rate as physicians for equal work.
  • Postpartum support services grants. From 2010-2012 , grants for state and local governments and community organizations are meant to provide education, treatment and support services to women with postpartum depression and their families.
  • Teen support services grants. The grants for teen support services programs are meant to provide "personal responsibility education programs for adolescents, as well as establish maternal, infant and early childhood visitation programs to provide in-home services to pregnant women and new families. These grants will be implemented from 2010-2014.

The new provisions under health reform may expand your coverage, so that you and your baby have the health insurance benefits that you need.