Tuesday October 6th, 2015 2:37PM

Pregnant women gain new options under health law

By The Associated Press
WASHINGTON (AP) -- The health care law has opened up an unusual opportunity for some mothers-to-be to save on medical bills for childbirth.

Lower-income women who signed up for a private policy in the new insurance exchanges will have access to additional coverage from their state's Medicaid program if they get pregnant. Some women could save hundreds of dollars on their share of hospital and doctor bills.

Medicaid already pays for nearly half of U.S. births, but this would create a way for the safety-net program to supplement private insurance for many expectant mothers.

Officials and advocates say the enhanced coverage will be available across the country, whether or not a state expands Medicaid under the health law. However, states have different income cutoffs for eligibility, ranging from near the poverty line to solid middle class.

The main roadblock right now seems to be logistical: reprogramming state and federal computer systems to recognize that certain pregnant women have a legal right to coverage both from Medicaid and private plans on the insurance exchange. Technically, they can pick one or the other, or a combination.

States and insurers will have to sort out who pays for what.

Another big challenge will be educating the public about this latest health law wrinkle. It's complicated for officials and policy experts, let alone the average consumer.

"This is an issue where women are going to have to figure out, `I'm eligible for both, now how do I do that?'" said Matt Salo, executive director of the National Association of Medicaid Directors, which represents state programs. "But what a wonderful problem to have. This is a great problem to have from the consumer's perspective."

The cost impact for federal and state taxpayers is uncertain. Providing more generous coverage increases costs, but comprehensive prenatal care can save money by preventing premature births and birth defects.

Cynthia Pellegrini, head of the March of Dimes' Washington office, said many women might not have been thinking about maternity benefits when they signed up for coverage under the health law. After all, half of U.S. pregnancies are unplanned. Often consumers just focus on the monthly premium when they select a plan.

The cost of normal uncomplicated childbirth averages $5,000, said Pellegrini, and preterm births can cost more than 10 times that. Copayments and deductibles add up fast.

"A lot of women, particularly in a situation like childbirth, could end up with significant out-of-pocket costs," Pellegrini said. "If they are eligible for Medicaid, they could be protected from costs ranging from hundreds to thousands of dollars." Her group works to prevent birth defects by promoting healthy pregnancies.

Existing Medicaid policies, subsidized private coverage under President Barack Obama's law and an obscure Treasury Department ruling combined to produce the new options for pregnant women.

Medicaid is a federal-state program that covers low-income and disabled people. Before the health law, states offered special, time-limited coverage to uninsured pregnant women until their children were born. That coverage is not only for poor women; some states provide benefits to middle-class women as well.

Then came the Affordable Care Act, with federally subsidized private insurance for people who don't have a health plan on the job. The law, however, drew a line between Medicaid and coverage through the exchanges: If you're eligible for Medicaid you generally can't get government-subsidized private insurance.

That barrier fell away when the Treasury Department ruled that Medicaid's targeted insurance for pregnant women did not meet the definition of "minimum essential coverage" required by the health law. That's because the coverage is temporary and states can restrict the services the pay for.

The ruling last summer opened the possibility for pregnant women to tap both benefit programs, said Dipti Singh, an attorney with the National Health Law Program in Los Angeles.

"Usually you could only be in one or the other," said Singh. "This is different in that pregnant women are eligible for both."

But the ruling apparently came too late to program into the computers.

The option works differently depending on a woman's circumstances, Singh said.

Many women with low incomes would be better off sticking with Medicaid only because most states have opted to provide comprehensive services for expectant mothers.

But a woman in an exchange plan would be able to limit her cost-sharing and gain access to enhanced maternity benefits if she opted into Medicaid as well. She would not have to worry about her coverage running out after the baby is born, as Medicaid's maternity-only coverage does.
© Copyright 2015
All rights reserved. This material may not be published, broadcast, rewritten, or redistributed without permission.
Judge denies motions to move, delay Tsarnaev trial
Lawyers for Boston Marathon bombing suspect Dzhokhar Tsarnaev asked a federal appeals court Wednesday to overturn a judge's decision to not move his upcoming trial out of state.
10:02PM ( 9 months ago )
High court to adopt electronic filing of cases
The Supreme Court is belatedly developing an electronic filing system similar to those used in courts around the country, Chief Justice John Roberts said Wednesday in his annual end-of-year report.
7:57PM ( 9 months ago )
Storm brings snow, cold to West for New Year's
A blustery winter storm dumped snow and ice across the West on Wednesday, making driving treacherous in the mountains from California to the Rockies and forcing residents and party-goers in some usually sun-soaked cities to bundle up for a frosty New Year's.
5:19PM ( 9 months ago )
U.S. News
State DOT awards $48M contract for NE Ga. road project
The state Department of Transportation has awarded a $47.8 million contract for nine miles of work on a northeast Georgia road.
9:37AM ( 9 months ago )
Business News
Grass fire impacts rush hour traffic on 985
Rush hour traffic on I-985 was slowed by a grass fire Wednesay afternoon with one lane closed while firefighters fought the blaze.
10:19PM ( 9 months ago )
Hall County conviction, sentencing to be reviewed by SCOGA
The State Supreme Court has agreed to hear the appeal of a Hall County man when they reconvene in January.
2:37PM ( 9 months ago )
Maysville man dies from Banks County wreck
The Georgia State Patrol reports that alcohol and/or drugs were factors a single-vehicle wreck that claimed the life of a Maysville man in Banks County Tuesday night.
11:07AM ( 9 months ago )
Local/State News
GOP leader regrets talk to white supremacists; party leaders rally around him
House Republican leaders rallied around one of their own, Whip Steve Scalise, on Tuesday after he said he regrets speaking 12 years ago to a white supremacist organization and condemns the views of such groups.
6:08PM ( 9 months ago )
Conviction of Putin foe sets off protest in Moscow
President Vladimir Putin's chief political foe was convicted along with his brother on Tuesday in a fraud case widely seen as a vendetta by the Kremlin, triggering one of Russia's boldest anti-government demonstrations in years.
6:03PM ( 9 months ago )
More Georgians signing up for health insurance
A federal report says more Georgians have selected health insurance plans through a federally facilitated marketplace.
4:16PM ( 9 months ago )
UN is next stop for Obama after success with Iran, pope; top issues are IS, Syria, Russia
NEW YORK (AP) — Fresh from successes on Iran and with the pope, President Barack Obama still carried heavy burdens into critical meetings this week at the U.N. General Assembly.They include the threat...
3:31PM ( 1 week ago )
Stunning Congress, House Speaker Boehner announces plans to resign; tea party declares victory
WASHINGTON (AP) — Plunging Congress into deeper turmoil, House Speaker John Boehner abruptly announced his resignation Friday, shutting down a tea party drive to depose the nation's highest-ranking Re...
6:14PM ( 1 week ago )
Tornado heavily damages 10 homes but causes no injuries on island in South Carolina
JOHNS ISLAND, S.C. (AP) — A tornado quickly blew through a neighborhood on the South Carolina coast early Friday and blew out windows, knocked down trees and heavily damaged ten homes.The tornado touc...
5:08PM ( 1 week ago )
Caterpillar says it may cut more than 10,000 jobs by 2018, lowers 2015 revenue expectation
Caterpillar is planning another round of job cuts that could exceed 10,000 people through 2018, as the construction and mining equipment maker adjusts to downturns in key markets.That could amount to...
10:06AM ( 1 week ago )
Escaped tarantula grounds Atlanta-bound flight in Baltimore
An eight-legged creature that escaped in the cargo hold of a passenger flight from Baltimore-Washington International Airport to Atlanta's Hartsfield-Jackson International grounded the plane and sent passengers onto another flight.
By The Associated Press
9:06AM ( 1 week ago )