Colorado Governor Signs Bill Requiring Maternity Coverage On All Policies

Governor Bill Ritter signed Colorado House Bill 1021 into law last week, instituting what I consider to be one of the most significant changes to health insurance law in recent years.  The law will require all health insurance policies in Colorado to provide coverage for both maternity care and contraception, starting next year.  Without this law, people who purchase individual health insurance have very little in the way of options for maternity coverage.

Of course the down side to HB1021 is cost.  It remains to be seen what will happen to premiums once all policies cover maternity.  Governor Ritter already signed a bill that will require equal pricing on policies for both genders, so the cost of providing maternity care will be spread to both men and women (seems fair enough, since both have a part in making babies).  In addition, the cost of providing care will be spread across every policyholder, much the way it works in the group market (all group plans in Colorado cover maternity, which means that everyone with a group policy is paying for maternity care whether they use it or not).

The few individual policies that have offered maternity riders over the years have had to price the riders based on the fact that the only people who are likely to add a maternity rider are people who are planning to use it.  Very few people add a maternity rider to an individual police “just in case” – mainly because of the cost of the coverage.  But if the cost of providing maternity care is spread across all policy holders, all the time, including those who won’t become pregnant or have already had their children, it makes sense to assume that the price increase for each person will be far lower than the cost of the riders that have been available on a case-by-case basis over the years.

I’m sure that there will be complaints that it isn’t fair to make everyone have a policy with maternity coverage when not everyone will use it.  But most people do eventually have children, and HB 1021 will make it possible for people without access to group health insurance to get coverage for maternity care (which, as I mentioned last month, is pretty close to impossible now).  I would love to see health insurance carriers expand maternity coverage to include access to midwives and home births, but providing access to maternity coverage for most women who buy their own health insurance is a good start.

About Louise Norris

Louise Norris has been writing about health insurance and healthcare reform since 2006. In addition to the Colorado Health Insurance Insider, she also writes for healthinsurance.org, medicareresources.org, Verywell, Spark by ADP, and Boost by ADP, and Gusto. Follow on twitter and facebook.

Comments

  1. It seems now that the only real trick left in the bag is to make all individual coverage guaranteed issue. While this move would play hell with premiums, it would level the playing field between individual and small group coverage. It would stop the current siphoning-off of healthy risks from small group into the individual market. Guaranteed issue would pave the way for merging the individual and small group markets and the advent of exchanges.

    BTW… Golden Rule fired the first shot in the commission war with their recent letter to brokers indicating a drop in commissions coming later this year. They blamed it on MLRs. I’d bet it’s broader based than that.

  2. I think the link in the first line goes to an outdated and significantly different version of the bill. I believe the final version of the bill is: http://www.leg.state.co.us/CLICS/CLICS2010A/csl.nsf/fsbillcont3/A28E94F66888D69A872576A8002891B3?Open&file=1021_enr.pdf

  3. Michael – You’re correct. I’ve been using the final bill in more recent posts, but I just went back and updated this post to include the final version. Thanks!

  4. This is more Communism. Why should a woman, long past child bearing age, be forced to pay for maternity coverage she obviously is not going to use? This will make my premium so high, I won’t be able to afford health insurance. So in order for OTHER people to get coverage, my premiums will go so high, I can’t afford MY OWN, so I’ll be yet another person without coverage, plus I’ll be one less person who gets stolen from to pay for everyone else’s insurance.
    This is absolute insanity.
    It isn’t surprising that Ritter signed such an unfair bill into law. This is, essentially, more redistribution of wealth. People aren’t going to be able to afford health insurance any longer, will then be forced into a single payer system, and health insurance companies will go out of business, but then again, that’s the plan – absolute government takeover of the health insurance industry.

  5. http://en.wikipedia.org/wiki/Communism

    http://en.wikipedia.org/wiki/Hyperbole

    I doubt the actuaries are adding extra premium for maternity coverage to insureds long past child bearing age.

  6. Okay, Kada, so young, dying-to-conceive adults like my husband and I must be screwed out of coverage because you’re too selfish to pay your share into society? Remind me of that when you’re eating cat food because all of your money is going to pay for prescriptions or your mortgage. My husband is self-employed and I work for a small non-profit. We pay taxes around 25% to pay for things like this so we ALL have an equal chance. Is it fair that my husband and I have to go $20K in debt so we can start a freaking family? You don’t see anyone bitching because old people need food or shelter. Why is it any less of a community effort for those that just want to have a family like everyone else? I’m sure glad the rest of the world isn’t as selfish and self-absorbed as you are. And it’s not Communism. It’s called being human and caring for the rest of your community. But again, remind me why that’s not the case when you’re living off Medicare in a nursing home or forced to choose between your heat or prescriptions because your Social Security doesn’t pay for all of them. Guess that would just be “redistribution of wealth”? Really.

    • Dear miss make everyone else pay for your responsibilities. I have individual coverage for my wife and I and when we wanted to have another baby, we PAID extra for a
      Maternity rider. So twice now we have paid our fair share. Now you want me to pay for your responsibility? If you can not afford something guess what you don’t get it. When will this redistribution stop? If you can’t afford to make a family then how in your delusional mind will you be able to support one. Im tired of all you lefties complaining about everyone paying their fAir share when you are not the ones making the sacrifice. It is very easy to be generous with other peoples money. If you need charity, ask for it. Don’t demand that someone else give you your wants

      • JayInColorado says

        Adam, I don’t know  when you and your wife purchased your maternity rider, but unfortunately such riders had become very scarce by the time this bill was introduced.  Ten years ago, lots of individual policies in Colorado could be purchased with a maternity rider.  But over the years most of the major carriers stopped offering this option. Basically what had happened was that people who purchased their own health insurance had little or nothing in the way of maternity coverage options.  This is in stark contrast to anyone who is covered by a group health insurance plan, since those cover maternity for everyone enrolled in the plan.  HB1021 helps to make individual coverage a bit more similar to what people get when they have group health insurance.  If an employer doesn’t offer health insurance and the employees have to seek out their own plans, at least their policy will now be a bit closer in terms of coverage to what they would get if the employer did offer group coverage.This made individual plans more attractive, which is what the carriers wanted. The mandate actually did very little to affect rates. The expensive risk, complications, were already covered.

        The Division of Insurance also released a detailed report showing the various factors that are driving the current round of rate increases. 
        http://www.dora.state.co.us/insurance/consumer/fhcr/fhcrRatingDemographicFactorsAffectingHealthPremiums110410.pdf

    • Dear miss make everyone else pay for your responsibilities. I have individual coverage for my wife and I and when we wanted to have another baby, we PAID extra for a
      Maternity rider. So twice now we have paid our fair share. Now you want me to pay for your responsibility? If you can not afford something guess what you don’t get it. When will this redistribution stop? If you can’t afford to make a family then how in your delusional mind will you be able to support one. Im tired of all you lefties complaining about everyone paying their fAir share when you are not the ones making the sacrifice. It is very easy to be generous with other peoples money. If you need charity, ask for it. Don’t demand that someone else give you your wants

      • JayInColorado says

        Adam, I don’t know  when you and your wife purchased your maternity rider, but unfortunately such riders had become very scarce by the time this bill was introduced.  Ten years ago, lots of individual policies in Colorado could be purchased with a maternity rider.  But over the years most of the major carriers stopped offering this option. Basically what had happened was that people who purchased their own health insurance had little or nothing in the way of maternity coverage options.  This is in stark contrast to anyone who is covered by a group health insurance plan, since those cover maternity for everyone enrolled in the plan.  HB1021 helps to make individual coverage a bit more similar to what people get when they have group health insurance.  If an employer doesn’t offer health insurance and the employees have to seek out their own plans, at least their policy will now be a bit closer in terms of coverage to what they would get if the employer did offer group coverage.This made individual plans more attractive, which is what the carriers wanted. The mandate actually did very little to affect rates. The expensive risk, complications, were already covered.

        The Division of Insurance also released a detailed report showing the various factors that are driving the current round of rate increases. 
        http://www.dora.state.co.us/insurance/consumer/fhcr/fhcrRatingDemographicFactorsAffectingHealthPremiums110410.pdf

  7. Dear Enraged:
    I went for years as a self-employed (self insured) having to pay extra for maternity option, so I sure don’t want to pay for yours now. But more importantly, there are many huge income tax benefits, some obvious some hidden,(as well as ‘family’ and ‘child’ discounts at any number of recreation facilities, events, and so forth) that discriminate against single people and especially people without children. And adding more bodies to the planet is hard on the planet, pushing it closer to its destruction: we have a severe overpopulation issue. So get off your high horse about your rights to reproduce and how other people should share the cost. I don’t know where you live, but in my county the property tax rates are outrageous, and as a small time real estate investor I am disgusted by how much money I and others pay for public schools to educate the children of people who oftentimes aren’t even citizens much less property owners themselves. Be a little sympathetic to other points of view.

  8. sunshine seeker says

    Dear enraged, If you want a grand piano because you feel a need to make music, than save your money and buy it yourself. more power to you. Don’t demand or expect that your community (or those of us who don’t even want to be in your freaking community) will buy it for you.
    If you gotta have a baby, than do it the old school way, and quit wining how much money it is going to cost you. It is, after all, only the beginning of your expenses, or do you want the rest of us to raise it for you also? Why don’t we just pay for your nanny to while were at it?
    People’s desires should be covered by the people who are desiring them, or were you taught to borrow off the good will of others?

  9. single man says

    why the hell should I as a single man pay for maternity benefits? Louse says” “seems fair enough, since both have a part in making babies” She assumes I am having sex, or irresponsible sex, with women.
    My insurance just went up by 60% this year due to this mandate. Idiots!

  10. single man says

    ” But most people do eventually have children” … please provide facts and data on that, libtard.

  11. Single Man,

    Did your insurance carrier tell you that your premium increased by 60% specifically because of the maternity mandate, or was your total rate increase 60%? If it’s the latter, the Colorado Division of Insurance recently released a detailed report showing numerous factors that all play a role in the rate increases this year:
    http://www.dora.state.co.us/insurance/consumer/fhcr/fhcrRatingDemographicFactorsAffectingHealthPremiums110410.pdf

    You asked for facts to back up my statement that “most people do eventually have children”. PewResearch data shows that in 2008, 18% of women age 40 – 44 had never had children:
    http://pewresearch.org/pubs/1642/more-women-without-children

    Some women do have their first child when they are older than 40, so the number that are childless at the end of their lives may be less than 18%. But even if we go with 18%, that means that 82% of women do eventually have at least one child. And each of those children also has a biological father. I would consider 82% to be “most Americans”.

  12. single man,
    I understand your frustration, but somebody was pulling your leg when they gave the maternity mandate as the main reason for your rate increase. You can call me at (720)352-7561 and I can explain what went into your increase based on your carrier, your plan and your age.
    I’ll let your insults slide this time. But if you post anymore hateful comments and call people names, the comments will be deleted and you’ll get banned.
    Jay

  13. married woman with adult children says

    People should be able to state their opinions without name-calling and generally being disgusting. Other folks are less likely to listen when the person is rude, so this type of language isn’t helping their cause.

    To people who are upset that they are paying taxes for schools when they no longer have school-age children: Schools educate the children who grow up to be the adults who run the cash registers in stores where you shop, the children who grow up to become the medical professionals that you see when you get sick, and the children who grow up to be all those other people you rely on to do their jobs. Do you really want to short-change the education of children just because you don’t have any children in schools at that point in time?

    To those folks who say they won’t be able to afford their premiums because they will be too high with the required maternity coverage: How do you know this? You haven’t a clue how much this mandate will add to your health insurance premium.

    @Enraged — Just FYI, Medicare pays for only about 3 months in a nursing home, e.g. if a person who is old enough to qualify to Medicare breaks both legs and needs more care than can be provided in their home while they are recovering. Medicare also pays for “regular” health care. Medicaid is for people who are poor enough to qualify for it. Medicaid will pay for nursing home care.

  14. Share your thoughts on the maternity requirement on Facebook:
    http://www.facebook.com/permalink.php?story_fbid=176239819127469&id=56646371180

  15. I don’t know how you’re all so quick to point fingers at this mandate. I don’t have kids either and may never need this benefit, but my rates have always hiked just as much.

  16. I don’t know how you’re all so quick to point fingers at this mandate. I don’t have kids either and may never need this benefit, but my rates have always hiked just as much.

  17. “…so the cost of providing maternity care will be spread to both men and
    women (seems fair enough, since both have a part in making babies).”

    Are you kidding me? I am a single male in my 30s, how am I responsible for substantially shouldering the cost of “making” babies? My individual plan premium just went up 40% – yes, that’s 4-0 P-E-R-C-E-N-T, due to me having to now cover maternity care for whomever, or everybody. Not a few dollars more for the greater good (which I am ok with), but 40%.

    And I am enraged about it. What logic is there here? I am the healthiest 39 yr old around, and through no action of my own my rates have just skyrocketed for some maternity care I have no stake in. It’s makes you want to switch parties.

    • In the past, maternity coverage on individual policies was an add-on (and not available at all on most policies), and could only be added to a woman’s coverage, even though babies have mothers and fathers.  And the majority of Americans – men and women – do eventually have children. 

      For years, group health insurance has covered maternity on all policies, regardless of gender or whether the insured has any intention of ever having children.  The new law in Colorado brings individual policies more in line with what group plans have long provided.

      In addition, if you health insurance premiums went up by 40%, I can assure you that it was not all (or even mostly) due to the new law requiring maternity coverage.  The Colorado Division of Insurance released a report detailing all of the factors that drive rate increases, and the maternity law is just one of a very long list of reasons rates continue to climb: http://www.dora.state.co.us/insurance/consumer/fhcr/fhcrRatingDemographicFactorsAffectingHealthPremiums110410.pdf

      Rate increases on individual policies vary tremendously from one carrier to another, from one year to the next, and even from one zipcode to another.  And as the DOI pointed out, health care reform legislation (both state and federal) only accounts for a fraction of the rate hikes we’re seeing this year. 

      Please feel free to contact us if you’d like to us compare rates from other carriers for you to see if you can get a better price for your coverage.

      • Yes I read all that. It still doesn’t make sense or apply to my needs/health. Making parity for men and women is more defensible, sure. Let me repeat that I am a singe male in my 30s with no babies, and my rate went up 40%.

        The for-profit healthcare system in this country is a disgraceful mess. It’s rate hikes on top of rate hikes on top of rate hikes…

        And there’s nothing anyone can or will do about it.

        • You might want to check out the transparency tools that the Colorado Division of Insurance added to their website with regards to rate filings: http://doraapps.state.co.us/Insurance/Consumer/pages/reviewStats.aspx  There’s a lot of interesting data there – stuff that applies to the entire market in general, and also specific rate history details on the major health insurance carriers in the state.

          You’re right that the healthcare system is a mess. Continued double digit annual rate hikes is not a sustainable model in the long run.  But the requirement that maternity be covered on all individual policies likely only accounts for a small fraction of the 40% rate increase you just got.  

          The point of health insurance is to spread risk.  I’ve never filed a claim for anything other than routine preventive care  (I have two children but I had them before maternity coverage was mandated on individual policies), and yet my rates keep climbing by double digit amounts every year (usually between 10% and 40%).  My own medical history and health status have nothing to do with my rake hikes.  Those are based on the combined claims experience for the entire pool of insureds.  And really, that’s how it should be.  If I did have a catastrophic health problem and needed half a million dollars worth of care one year, I’d hate to have my next year’s rate hike be based on my personal claims history.   

  18. “…so the cost of providing maternity care will be spread to both men and
    women (seems fair enough, since both have a part in making babies).”

    Are you kidding me? I am a single male in my 30s, how am I responsible for substantially shouldering the cost of “making” babies? My individual plan premium just went up 40% – yes, that’s 4-0 P-E-R-C-E-N-T, due to me having to now cover maternity care for whomever, or everybody. Not a few dollars more for the greater good (which I am ok with), but 40%.

    And I am enraged about it. What logic is there here? I am the healthiest 39 yr old around, and through no action of my own my rates have just skyrocketed for some maternity care I have no stake in. It’s makes you want to switch parties.

    • In the past, maternity coverage on individual policies was an add-on (and not available at all on most policies), and could only be added to a woman’s coverage, even though babies have mothers and fathers.  And the majority of Americans – men and women – do eventually have children. 

      For years, group health insurance has covered maternity on all policies, regardless of gender or whether the insured has any intention of ever having children.  The new law in Colorado brings individual policies more in line with what group plans have long provided.

      In addition, if you health insurance premiums went up by 40%, I can assure you that it was not all (or even mostly) due to the new law requiring maternity coverage.  The Colorado Division of Insurance released a report detailing all of the factors that drive rate increases, and the maternity law is just one of a very long list of reasons rates continue to climb: http://www.dora.state.co.us/insurance/consumer/fhcr/fhcrRatingDemographicFactorsAffectingHealthPremiums110410.pdf

      Rate increases on individual policies vary tremendously from one carrier to another, from one year to the next, and even from one zipcode to another.  And as the DOI pointed out, health care reform legislation (both state and federal) only accounts for a fraction of the rate hikes we’re seeing this year. 

      Please feel free to contact us if you’d like to us compare rates from other carriers for you to see if you can get a better price for your coverage.

      • Yes I read all that. It still doesn’t make sense or apply to my needs/health. Making parity for men and women is more defensible, sure. Let me repeat that I am a singe male in my 30s with no babies, and my rate went up 40%.

        The for-profit healthcare system in this country is a disgraceful mess. It’s rate hikes on top of rate hikes on top of rate hikes…

        And there’s nothing anyone can or will do about it.

        • You might want to check out the transparency tools that the Colorado Division of Insurance added to their website with regards to rate filings: http://doraapps.state.co.us/Insurance/Consumer/pages/reviewStats.aspx  There’s a lot of interesting data there – stuff that applies to the entire market in general, and also specific rate history details on the major health insurance carriers in the state.

          You’re right that the healthcare system is a mess. Continued double digit annual rate hikes is not a sustainable model in the long run.  But the requirement that maternity be covered on all individual policies likely only accounts for a small fraction of the 40% rate increase you just got.  

          The point of health insurance is to spread risk.  I’ve never filed a claim for anything other than routine preventive care  (I have two children but I had them before maternity coverage was mandated on individual policies), and yet my rates keep climbing by double digit amounts every year (usually between 10% and 40%).  My own medical history and health status have nothing to do with my rake hikes.  Those are based on the combined claims experience for the entire pool of insureds.  And really, that’s how it should be.  If I did have a catastrophic health problem and needed half a million dollars worth of care one year, I’d hate to have my next year’s rate hike be based on my personal claims history.   

  19. “…so the cost of providing maternity care will be spread to both men and ?women (seems fair enough, since both have a part in making babies).”??

    Are you kidding me? I am a single male in my 30s, how am I responsible for substantially shouldering the cost of “making” babies? My individual plan premium just went up 40% – yes, that’s 4-0 P-E-R-C-E-N-T, due to me having to now cover maternity care for whomever, or everybody. Not a few dollars more for the greater good (which I am ok with), but 40%.??

    And I am enraged about it. What logic is there here? I am the healthiest 39 yr old around, and through no action of my own my rates have just skyrocketed for some maternity care I have no stake in. It’s makes you want to switch parties.?

  20. lisacolorado says

    We got our insurance raised by two hundred and fifty a month. Great.

    • Let me know if you’d like me to compare your options (720)352-7561. Or you can start by browsing on your own: http://bit.ly/seequotes

  21. lisacolorado says

    We got our insurance raised by two hundred and fifty a month. Great.

    • JayInColorado says

      Let me know if you’d like me to compare your options (720)352-7561. Or you can start by browsing on your own: http://bit.ly/seequotes

  22. You guys are lucky. In Florida, the sneaky insurance companies don’t even tell you maternity is not covered in individual plans, nowhere is it mentioned, not in the application, not in the quote, not in the screening forms, NOwhere, the reps selling it (unless they’re seasoned) don’t even know themselves because it requires a lot of digging to find the answer…but it IS written as a 2-liner on page 5x of the 65+ page insurance contract that you receive AFTER you’ve paid the first month premium, and they don’t even deliver said contract within the 30 day “freelook” period (but their accts dept will swear it was sent out on day 1)….out of the 30+ companies that offer health insurance in Florida only 3 offer maternity coverage, and the hoops people have to jump through to “qualify” and even then they will not cover it on the contract from day one, there is a 90/180/365 day “pre-existing condition” depending on the company that they will hide behind just to not have to cover maternity. (yes and I do know that you cannot be prego prior to signing on)…..so basically, if someone wants maternity coverage, depending on the carrier, they will have to wait either 90, 180, or 365 days before the policy will cover it….all the while the insurance company is collecting the higher premium during the “no maternity coverage” period…prior to our current gov, his predecessor made it a point to tell insurance companies to shape up or ship out toward the end of his term, he wanted them to “offer” the coverage, not exclude it all together and hide the fact that they are excluding it until it’s too late, let the consumer decide whether or not to take it, like would you like a $2,500 deductible or a $5,000 deductible…would you like maternity coverage or no maternity coverage…but then the new governor dickhead came in and said fuhgidabadit come back and screw our citizens sideways to all those ins companies that left our state…there are hundreds and hundreds of people every month with individual insurance who end up getting pregnant (whether planned or by chance) and finding out that their individual insurance doesn’t even cover maternity…so what do they do, well there is apparently some kind of law that states that a hospital has the obligation to provide service to an expectant mother and her child (labor and delivery, as well as any future care of the “infant only” related to follow up care due to the conditions of the delivery), and if the mother says she cannot pay nor does she have insurance then the hospital (apparently) cannot bill the mother and so the state will pay the whole tab…now, bear in mind, i do not know the specifics of how this works, i’ve just heard this from many ob/gyn doctors and many who went through it personally…oh and by the way, of the 3 carriers that do offer maternity coverage, 1 of them is considering to drop it all together because as they say it’s not profitable to them to offer it in florida…thanks gov dickhead…now, i don’t think the maternity coverage should be mandatorily (even a word?) included in everyone’s policy, but i do think that EVERY ins company should OFFER it and it should be up to the consumer to reject it, and they should have the ability to add it back when they want as long as they are not prego while trying to add it back on…but for companies to NOT even offer it is total CRAP….yeah we’ll cover health, sickness, of any living person on the plan but not the birth of anyone nor the mother going through the pregnancy and delivery of a new baby, they can suffer/die and go to hell, but we’ll cover the other non-prego, non-babies-being-born, and non-preterm mothers, Eff the people who really need the care, let them rack up the $20+ G’s in hospital bills to have a baby…OH and then these new parents get to add their newborn to the CRAPPY ins plan and have the ins company’s greedy effing rates go up as they rub their hands together like the grinch happy to be getting more money for nothing…

  23. Sam, What you’re describing is quite similar to what we had in Colorado prior to HB1021 becoming law. Over the years, most of the major health insurance carriers had stopped offering the option of adding maternity riders to their policies. It simply wasn’t profitable. This makes sense, since the only people who were adding the maternity coverage were the people who were planning to use it. So it didn’t work like most insurance, where you get the policy and then hope you never have to use it. Thus it became a money-loser for insurance companies. The carrier that was was still offering it prior to HB1021 was charging several hundred dollars a month (somewhere in the $500 – $700/month range, if I remember correctly) to add maternity.
    Now that maternity is on all policies automatically, the cost is spread across the entire insured population rather than being concentrated only on the people who have specific plans to use the coverage. And the Colorado Division of Insurance has indicated that so far, the premium increase associated with mandatory maternity coverage has not been significant.

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