Damned if she works, damned if she doesn’t...

This REALLY just makes me ANGRY. Earlier today I received a call from a mom who was in tears and frustrated because she found out that her health insurance excluded maternity and because she is a working, tax paying contributing member of society she was denied Medicaid. Ok, so here’s my rub and believe me when I tell you I have heard this story hundred’s (No Exaggeration) of times. She was told by her Medicaid Caseworker that if she quit her job she would be able to get Medicaid to pay for her baby. ARGGGGG!!! This is a solution??? Quit contributing and the government will pay. I have a better idea, how about you keep your job and we make pregnancy affordable for moms and quit taking advantage of women who are in this situation. This is UNFAIR and INSANE!!!

So what's the deal? Why is this happening? And what do brain tumors, heart conditions and pregnancies have in common? According to insurance companies, they’re all preexisting conditions. That catch-22 leaves many pregnant women uninsured.

Though federal law (HIPPA) prohibits insurance companies from considering pregnancy a preexisting condition, there’s a caveat. A woman can be excluded from a policy if she was uninsured prior to applying for coverage. So a pregnant woman can switch insurance companies if she changes jobs. But if she’s been uninsured, she’ll stay uninsured.

Even on the off chance a woman can find an insurance company to take her, the coverage can be downright unaffordable. Deductibles for individual insurance policies can be ten times what they are for group policies. Since the average uninsured woman occupies the low-income bracket, that option quickly becomes unreasonable. She could be spending as much as a third of her income on insurance, an insurmountable price tag for someone already struggling to make ends meet.

So why doesn’t she simply apply for Medicaid?

Medicaid eligibility varies by state. In West Virginia, she can make $12 thousand a year; in New York, she can make just over $20 thousand. Before taxes. If she makes anything more than minimum wage, she’s no longer eligible. Since nearly 60% of low-income women work, many of them are never eligible for government care.

No coverage often equates to no prenatal care. But it’s no wonder so many women do without appropriate health care. When it comes to choices, most uninsured pregnant women don’t have any.

Resources:

Women’s Health Insurance Coverage Fact Sheet, December 2007
http://www.kff.org/womenshealth/1613.cfm

West Virginia Medicaid Eligibiligy
http://www.wvdhhr.org/bcf/family_assistance/medicaid.asp

New York Medicaid Eligibility
http://www.health.state.ny.us/health_care/medicaid/#income

Cost of Individual Insurance
http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=221493