In the search to find good maternity insurance California mothers have found fewer options to choose from over the last few years. However, new mandates in 2012 will require that all health insurance plans in California provide maternity health coverage. Both the Individual/Family plans as well as the Group plans will be affected by these new rules, which take effect on July 1st, 2012.
Senate Bill SB222 by state Senator Noreen Evans, and Assembly Bill AB210 by Assemblyman Roger Hernandez, were both signed by Governor Jerry Brown on Oct 6th. These two bills require that every health insurance plan offered in California must provide maternity insurance coverage. This change will reshape the maternity health insurance marketplace in California by expanding the health insurance options that are available.
Forced To Provide Maternity Insurance California Could Lose Insurance Companies?
Currently there are 23 California maternity health insurance plans offered by the major insurance companies. That’s out of a total of 164 individual & family health insurance plans, so only 14% of the individual health insurance plans offer maternity coverage. Anthem Blue Cross, Blue Shield of California, Health Net, and Kaiser Permanente, and PacifiCare/UHC are the primary insurance companies that offer a few individual maternity plans. Aetna and CIGNA do not offer any maternity insurance California plans, so it will be interesting to see whether they leave the market in this state, or put maternity coverage into their plans.
Adding maternity coverage to all health insurance plans is also part of the Health Care Reform package that is scheduled to take effect in 2014, so California is simply accelerating the time schedule. Blue Shield of California and Kaiser Permanente supported the legislative change. Blue Shield believes that maternity coverage should be a core benefit of health insurance, so the costs of prenatal care and delivery are spread across everyone, instead of just families wanting children.
So far there has been no word on how this change will effect the rates of health insurance plans in 2012. However legislative analysis of the provisions show an average increase of just under $7 per policy. This projection does not come from the insurance industry, so the actual increase is still unkown.
The state government will probably be the biggest beneficiary of these new rules, and should save millions on reduced expenses in the Medi-Cal and Access For Infants and Mothers (AIM) programs. These joint federal and state programs are the insurer of last resort for many California mothers that have no maternity health insurance. It is expected that more un-insured mothers will be able to afford maternity care after SB222 takes effect next year.
All this being said, there is still one glaring hole still left unfilled. The insurance companies do not have to provide health insurance for pregnant women in individual health insurance plans, and SB222 and AB210 do not change this. So planning to have a baby is still important. That way the family can get the necessary maternity coverage before the pregnancy happens. If not, then the California Pre-existing Condition Insurance Plan will continue to be the only insurance option for a self employed pregnant woman.