California, New York bills would make pregnancy a qualifying event

Dive Brief:

  • The California Assembly has approved a bill to designate pregnancy as a qualifying life event to allow women to purchase health plans through Covered California outside of the regular open enrollment period. The bill is now set for review by the state Senate.
  • In New York, three separate bills have been drafted with the same goal, in a bid to increase the odds that a version will be passed.
  • Moves like the one in California could influence federal policy on the issue, suggests Christina Postolowski, health policy manager at Young Invincibles. 

Dive Insight:

Opponents argue that designating pregnancy as a qualifying event would allow too many women to wait until they need coverage before buying it and that this in turn it would drive up costs.

As Nicole Evans of the California Association of Health Plans told KPCC News, "The goal is for all Americans to have coverage, and if we start to provide exceptions for people to wait to get coverage until they have a need, you could be undermining the goals of the [ACA]."

Supporters make a compelling cost argument too, however. March of Dimes officials pushing the New York legislation suggest the state could save more than $1 billion each year by preventing premature births and other issues. They note that the average cost for a premature or low-birth-weight infant is 12 times the cost for a healthy infant, and that one in seven babies in New York is born after receiving inadequate prenatal care.

Filed Under: Payer
Top image credit: grietgriet/Morguefile