Paying for Male Pregnancy and Newborn care for Post-menopausal Women. Obamacare a Bad Insurance deal, a Continuing Series

“I also have a healthcare plan that would save the average family $2,500 on their premiums”.
President Obama on the Campaign Trail, 2008.


Many Americans are being hit with sticker shock on the increased health insurance costs under Obamacare, as previously reported here.  Many people are shocked to learn that part of the increase in their premium is that the insurance under Obamacare is mandated to cover maternity and newborn care – for people who can’t get pregnant! All men and all post-menopausal women must buy the same insurance plan with the same benefit as women of child bearing age.  “Maternity and Newborn Care” is listed as one of ten “essential health benefits” under subsidized policies in Obamacare.  The benefit does not say “maternity care for women of child bearing age”, but for all policies.  That means if you are a man or a woman who can’t have babies, you are paying for insurance coverage you will never need and your total health insurance bill is higher than it needs to be. Welcome to “one size fits all” health insurance.

Government mandated health insurance benefits have long been associated with unnecessarily higher health insurance bills for decades.  Those who support and oppose them all agree that before Obamacare health insurance mandates were generally adding anywhere from 1-5% to the average monthly premium.  In the past these included things like hair prosthetics (wigs) for chemotherapy, chiropractic care, acupuncture and more advanced treatments like in vitro fertilization. The efforts to include mandated benefits has led to a never ending parade of lobbyists pushing to have their special interest “covered” so they could divert that coerced money into the pockets of their organization’s members. Some states had more mandates before Obamacare (like Massachusetts) while others had fewer (like Utah) and this accounted in part for the wide difference in health insurance costs between states with lower-mandate states having lower costs.  The Council on Affordable Health Insurance has long analyzed this issue and reported on 2,271 mandates in 2012 across the nations divided among states.

However, the maternity mandate brings the costs of mandates to a much higher level.  The cost of health insurance is so dramatically increased in young men that it substantially erodes the planned federal subsidy for their health insurance under Obamacare.  When Obamacare passed, many who supported it proudly proclaimed that the impact would be an equalization of health insurance premiums for men and women, based in part on the maternity care mandated.  The proponents had indicated that ending the practice of “gender rating”, would bring an end to the days of health policies for women costing 150% more than those of men.  The only problem is that men are now being forced to pay for care they will never receive, which amounts to a subsidy for those women who receive newborn and maternity care.  That same negative impact of higher premium extends to women who are post-menopausal or who can’t have children due to sterilization or hysterectomies.  So while mandates in the past generally increases premiums in the single digits, the premium impact for many is up to 25% higher of the maternity benefit alone. CMS benchmark insurance plans with “Essential health benefits” under Obamacare for Florida is the BCBS “Blue Options 5462” plan which includes Maternity care regardless of the sex of the patient or the ability to bear children (see Row 23).

In the past, people could decide what care to purchase based on their needs.  A family man would add his wife onto his policy to cover her pregnancy, and pay the increased cost. A young man who was unmarried would buy lower cost health insurance to cover his needs, not the needs of women in another state that may have a baby.  Women who had a hysterectomy or who had reached menopause would get a break on that segment of their health insurance by not paying for maternity care.  To be sure, there were still major problems with choice and selection of health plans before Obamacare since people couldn’t get the same tax break for insurance if they bought it outside of the workplace. But those problems have other solutions.  The fact is that Obamacare’s health insurance requirements are dramatically driving up the health insurance costs for tens of millions of Americans. That is a broken promise by a President that famously guaranteed that health insurance premiums would be $2,500 lower by the end of his first term.

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One Reply:

  1. tom48212

    The cost of man’s Health Care makes me wonder if he had insurance for pregnancy all along? Males and females always paid the same for health care insurance thru their employers did they not? That being the case the man was covered for pregnancy, the woman was covered for a vasectomy and the costs of the insurance coverage was averaged out between the two and shared accordingly.

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