Lately I’ve been pondering the expenses involved with having a baby. Jay and I have been married four years, and we’ve started discussing the idea. Obviously, there are enormous costs that continue to accrue over the years – everything from cribs to college, most of which can be lowered through frugal living. But what about the actual expense to have the baby in the first place? At clients’ requests, I’ve spoken with several ob/gyns and hospitals around Denver to see what they charge. For healthy pregnancies with vaginal deliveries, I’ve been quoted anywhere from $6,000 to $15,000. (This is before any insurance adjustments). For people who work for an employer that provides group health insurance, maternity care is covered on their health insurance policy. The deductible may be higher than they would like, but the coverage is there. Many employees never even have to think about how they will pay for the pregnancy – they just know that their insurance will cover it. I have a friend who paid about $100 for her entire pregnancy, including the delivery.
But for the self-employed, the options are a bit trickier. Group of one (or two) policies are much more expensive than individual policies. When you’re paying the whole premium yourself, it can be a painfully large chunk of money each month. Individual policies with maternity coverage are available from a few Colorado health insurance carriers, but they tend to be expensive and still leave the insured with a big bill. Complications of pregnancy are covered on all health insurance policies in Colorado, but basic maternity and delivery charges are almost never covered on individual policies.
With more and more employers shying away from offering insurance for employees, the number of women facing the costs of a pregnancy without maternity coverage is bound to increase. For a family earning $50,000/year, a $10,000 medical bill is a huge burden. Is it fair that a person who earns $40,000/year working for an employer who provides great medical coverage might end up paying $300 to have a baby, while an employee who earns $40,000/year working for an employer who does not provide health insurance will pay the entire $10,000? Most people have children. But it is getting more and more expensive to do so. Perhaps maternity care is something that should be standardized with a single payer system, even if the rest of the health care system remains in the free market.
Since basic maternity costs are incurred by every woman who has a baby in an American hospital, regardless of her health or socioeconomic status, maybe those expenses should be split among all insurance companies, with a pool of money designated to cover all pregnant women. The women themselves would all have to pay a standardized amount – may $1000 or so – but it would be the same for everyone, regardless of the quality of the rest of her insurance policy. A woman could have the options to pay additional charges for more than the basic care, say extra days in hospital or an epidural. But no woman would be faced with several thousand dollars in out-of-pocket expenses for having a baby.
As for us, we’re planning to use a midwife and have a baby at home. The midwife we plan to use charges $3000, which is not covered by any insurance policies. So we’re putting money aside each month in our HSA so that we’ll be able to pay for her services. We would have a baby at home regardless of the cost relative to having one in the hospital, and we feel that $3000 is a very fair price for everything that the midwife will provide. But it’s definitely something that we have to plan ahead.
We talk all the time with couples facing the dilemma of how to pay for the costs of a pregnancy. I do think that there should be some expenses borne by the couple having the baby, but I think that it should be evenly distributed among everyone who has a baby, and among all insurance companies.