Vanessa Gonzalez Kraft tries to balance her traditional Mexican-American cultural heritage and Catholic identity, personified by her grandmother La Lupe, with her roles as a young wife and mother.
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An Uninsured Pregnancy (Health Care Part 1)
An uninsured pregnancy. Definitely not a boat expectant parents want to find themselves in. The common perception when you hear those two words together is that the mother must be poor, young, and uneducated. Wrong. This describes me and many other women I have met.
How did my husband and I find ourselves in this predicament? After Olivia was born, we decided I would be a stay-at-home-mom and we went down to a single income. We had the option of paying for insurance under Brandon’s new employer but it was just too expensive. We couldn’t afford it. We decided to find an individual plan and did a lot of research. We made sure the individual plan we found paid for well-visits and vaccines for Olivia, as well as eye, dental, etc. This individual plan, when compared to the employer insurance we were trying to substitute, looked identical but for half the price. Awesome. Until I got pregnant. I went to my first OBGYN appointment to confirm the pregnancy and to my total shock they returned my insurance card to me and told me that they don’t cover maternity care.
So while I do have health insurance, they do not pay for prenatal care, prenatal lab tests, labor and delivery, or postpartum care, unless there is a complication. In order for my insurance to pay for anything associated with the new baby, one of us has to be dying. I know; it doesn’t make sense to me either.
When I got home from my appointment Brandon and I immediately jumped on the computer to start researching and pulled out the insurance policies. Yup, sure enough. No maternity care. Man, did we feel stupid for such an oversight.
After more research, we realized that there was no way to have maternity care unless we paid for Brandon’s employer plan which would have taken 1/3 of Brandon’s paycheck. Texas and many other states do not require insurance companies to provide maternity coverage unless it is an employer plan that employs over 15 people. Because there is no law forcing insurance companies to cover pregnant women on an individual plan, they don’t do it. That means there is no possible way to buy insurance to cover maternity care if you are a woman who is self-employed, employed by a small business, has some kind of non-traditional job like an artist or musician, or works part-time and is not eligible for an employer plan. Or (like us) cannot afford the employer plan and has to find a less expensive alternative. This is a lot of women.
We realized our current situation was not simply us being careless but rather the health care system in place giving no support to pregnant women unless they fall into the aforementioned parameters.
In case you’ve never had to pay any hospital bills, they are very expensive. After Olivia was born we put all the bills together from prenatal care, labor, delivery, and postpartum and realized that if we hadn’t had insurance, we would be paying roughly the same amount it would cost to buy a new, compact car.
At this point, we started asking a bunch of people we knew in the medical field if they knew of any way we could get help paying the hospital bills that would soon be hounding us. The only answer – the government. The only way that we were going to get subsidized maternity care was either through Medicaid or CHIP. There was no way for us to qualify for Medicaid. Not even close. CHIP, while we were hopeful, didn’t work out either.
We even decided we would just suck it up and pay for Brandon’s employer plan, somehow dealing with the extreme decrease in income, but their open enrollment wasn’t going to happen in time for the baby’s birth. We’ve hit dead end after dead end.
There is truly something wrong with a health care system that does not make it easier to care for a pregnancy. I (and a lot of women in the same boat) am educated and responsible. We have health insurance, life insurance, home insurance, car insurance. We pay taxes, we vote, we are good citizens. I have never had to depend on the government to help me pay for anything and yet the only place we could turn to for help is the government — the only ones willing to help pregnant women with no insurance.
This has seriously shaped our view of President Obama’s health care reform. In looking for ways to help us pay hospital bills, we found out that some of the health care reform went into effect on January 1st of this year. Our hearts leapt because part of the reform is that insurance companies are required to include maternity care in all individual plans. Could we be that lucky? Would our insurance be forced to start providing maternity care just one month before the baby comes? Nope, that part doesn’t kick in until 2014. Ugh.
You might be wondering what the heck we are going to do. Well, we’re going to try to get through labor and delivery as inexpensively as possible. No IVs, no drugs for the pain, or anything else we can get away with refusing until it is absolutely needed. Of course if I need something we will gladly give in and take it regardless of how much it will cost but we’re going to do our best to keep costs down and hope that it’s enough.
So, do we need health care reform? Yes. More families than you would imagine need it. And not just nameless families. Our family.
Stay tuned: in my next post I’ll be writing about the reforms that are already scheduled to go into effect and the Church’s response.