Of all the changes that Obamacare has made to health insurance in the United States, one of the earliest and most well-known bits of legislation kept young adults on their parents' health care plans longer. Starting in 2010, insurance plans that extended coverage to dependents of the main beneficiaries were required to continue covering those dependents until they had reached the age of 26; previously, insurance providers could cut coverage to dependents aged 19 years and older.
This insurance law revision was met with much praise - young adults in an unstable job market could have a better guarantee to quality health care, and because many 20-somethings would choose to go uninsured rather than find their own policy, Obamacare's dependent provision has meant improving preventative health care and saving costs in emergency medical services. According to information from the White House itself, more than 3.1 million young adults are now on health insurance thanks to the Affordable Care Act.
However, there is one health care service that these under-26 dependents might not be receiving: maternity care.
On June 4, 2013, the National Women's Law Center (NWLC) filed a complaint with the Office for Civil Rights at the U.S. Department of Health and Human Services, claiming that some employers are violating federal law by not providing pregnancy services to health care policy dependents, and therefore are committing sex discrimination against women.
At Gonzaga University in Washington State, for example, the health insurance plan given to employees is like most workplace policies in that it provides coverage to workers' spouses and dependents as well. If a Gonzaga employee has a six-year-old daughter who falls and breaks her knee, her surgery, hospital stay and follow-up visits to the doctor will be covered by the family's insurance policy through Gonzaga.
But, although a Gonzaga coverage plan will pay for a broken knee, it will not pay for a dependent's pregnancy. In the 'Obstetrical Care' care section of the Gonzaga insurance policy, there is a clause stating that "pregnancy and childbirth are not covered for dependent children."
According to the NWLC, many other employers have similar policies. Not covering the pregnancy costs of dependent children might have made sense when most dependents were 18 years and younger; however, with young adults in their early and mid twenties now legally entitled to insurance coverage through their parents' health plans, a ban against maternity care is more note worthy. The Centers for Disease Control (CDC) estimates that the average age of childbirth in the United States is 25.4 years old, and the CDC also reports that in 2010, 2.4 million pregnancies occurred in women under the age of 25.
The National Women's Law Center has filed complaints of sex discrimination against five institutions (two universities, a non-profit research group, a health system and a state system of higher education), all of which receive federal assistance and are therefore required to follow federal law when providing employees with health insurance. Federal law prohibits sex-based discrimination of pricing and services, and since the passage of Title VII of the Civil Rights Act in 1964, employers must provide maternity coverage for women (and spouses of male employees) without making those workers pay higher premiums or deductibles.
Explaining more about the law center's legal filing earlier this month, NWLC Vice-President for Health & Reproductive Rights Judy Waxman has said that all five of the accused institutions are providing dependent women health benefits that are less comprehensive than those given to dependent men. Whereas a dependent male will be able to use his insurance coverage to seek all necessary medical treatment, a dependent woman cannot do the same if pregnancy services are not covered.
The NWLC discrimination complaints may come as a surprise to some of the accused institutions. The director of community and public relations at Gonzaga has said that the university is under the impression that their health insurance policy is in full compliance with federal law and the Affordable Care Act. Section 1557 of the ACA states that any health program receiving federal assistance must not discriminate on the basis of sex; according to the NWLC, Gonzaga University's health insurance plan does exactly that.
Clearly, the NWLC is hoping that by bringing these few cases into the public eye, more federally-assisted institutions will take a look at their own health insurance policies, and make sure than sex-based discrimination isn't occurring. Then again, considering the money necessary to provide maternity services (the non-profit foundation March of Dimes estimates the cost of pregnancy and childbirth to be more than $10,000), there is also a possibility that employers around the nation will come together and lobby for a regulation change to fight against the requirement of covering dependents' maternity care.
In the meantime, the NWLC is asking that the Office for Civil Rights to conduct an appropriate investigation to determine whether or not the five institutions cited have broken the law, and if dependents of employees are being discriminated against based on sex. The NWLC would also like the Office for Civil Rights to look into securing back payments for women who have already been affected by any no-maternity care policies.