Better have some savings stored
up before you rush to the delivery room: A new analysis shows the average
out-of-pocket expense for delivering a child in the United States is nearly
$3,000, even if you're insured.
Other studies have looked at the
costs for specific services, such as Cesarean sections versus
vaginal deliveries, but those are only a small part of the picture. The road to
recovery after giving birth can take a network of care, including a host of
doctors and even therapists. So, the Kaiser Family Foundation analysis took a comprehensive view of the cost of pregnancy,
including elements of post-delivery care.
"As someone who’s been
pregnant before, I know that’s not the only cost that comes up," said
Cynthia Cox, co-author of the analysis and a vice president at the Kaiser
Family Foundation (KFF). "There's postnatal care, postpartum care, but
other things that may come about as well, like physical therapy."
The analysis comes on the heels of the U.S. Supreme Court ruling that overturned the 1973 landmark Roe v. Wade decision guaranteeing women the right to an abortion. The new ruling could mean women who are denied abortions in states where the procedure is no longer legal could face hefty health care costs if they decide to have a child, even if they can't afford it.
To determine just how much
childbirth costs, the KFF researchers examined private insurance data from the
IBM MarketScan Encounters Database from 2018 through 2020, and compared the
average health spending for someone who gave birth versus someone who did not.
The investigators found that
pregnant women incurred an average of nearly $19,000 more in health care costs
than women who didn't give birth. That included the cost paid for by insurance
(averaged $16,011) and out-of-pocket expenses for the patient (averaged
$2,854.)
But that's just the cost of care
for the mother. Once the child is born it might have its own deductible. If the baby needs to go into the neonatal intensive
care unit or stay in the hospital for an extended period of time, that could be
its own set of costs.
"The $3,000 is shocking but
it's just the first expense, possibly even one of the lower expenses someone
can occur from giving birth in the United States," Cox said.
"Compared to other countries, they aren’t as likely to have this kind of
out-of-pocket expense for the birth, but also longer parental leave and better
access to childcare services."
It's not uncommon for soon-to-be
parents to "shop around" for the best delivery units in their area,
touring different facilities and meeting doctors, a practice that hospitals
encourage. With nine to 10 months to plan, couples have plenty of time to
figure out which hospitals are in-network and which doctors in those hospitals
are in-network. That's a level of planning simply not possible for most other
medical situations, such as emergency room visits or unexpected surgeries.
Still, people can end up with
surprise bills after giving birth.
"People and hospitals can
prepare for this, and it's still a very high-cost event," Cox said.
"Even though you may have shopped around, you may show up to the delivery
room and there's an anesthesiologist who’s
out-of-network and you get overwhelmed with a surprise bill."
Different kinds of deliveries can
cost wildly different amounts, as well. From pregnancy to postpartum, people
who give birth via C-section incur an average of $26,280 more in health care
costs than women who don't give birth. In contrast, this amount for women with
a vaginal delivery averages just under $15,000.
"One of the most common reasonsfor bankruptcy is medical expenses," said Dr. Jessica Peterson, a
maternal-fetal medicine fellow at the Icahn School of Medicine at Mount Sinai
in New
"I think one of the biggest
takeaways, when you include insurance premiums, is that one in five people will
suffer catastrophic health expenditures. Most people at most income levels have
a lower risk of catastrophic health expenditure if they have public
insurance," Peterson noted.
Four in 10 U.S. births are
covered by Medicaid, according to the KFF. But in some states where Medicaid has not been expanded
under the Affordable Care Act (also
known as Obamacare), coverage ends 60 days after delivery. After that mark, the
new parents are on their own.
"Some of the costs and
complications related to pregnancy can happen weeks or months after you
deliver, like postpartum depression,"
Peterson said. "We really need to reevaluate the way that public health
insurance is provided here."
More
information
Check out the KFF's Medicaid Postpartum Coverage Extension Tracker to see which states have expanded postpartum
Medicaid coverage.
SOURCES: Cynthia Cox, vice
president, Kaiser Family Foundation, San Francisco; Jessica A. Peterson, MD,
maternal-fetal medicine fellow in obstetrics, gynecology, and reproductive
science, Icahn School of Medicine at Mount Sinai, New York City; Kaiser Family
Foundation, news release, July 13, 2022
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