Here’s why people are paying more to get pregnancy care than ever before

Health

Hint: It has to do with the rising cost of health insurance.

Amid discussions about affordable healthcare, a new study from the Massachusetts Health Policy Commission (HPC) looked at why individuals have begun paying more and more for pregnancy care over the last few years.

What the HPC found is that the problem lies not with increases in the cost of care itself, but in ballooning out-of-pocket spending through deductibles.

What this means is that individuals are paying for a higher proportion of the cost of pregnancy than they did in the past, and the reason is high-deductible health insurance plans.

The study came to these conclusions by looking at out-of-pocket (OOP) spending for healthcare related to all parts of the pregnancy process, from conception to post-partum care, for people in Massachusetts.

OOP spending is the portion of healthcare costs paid for by individuals. This includes deductibles, copays, and coinsurance, which are paid for by the patient.

The HPC used commercial health insurance cost data from 2016 to 2018 to evaluate OOP spending for those years.

What the HPC found is that deductible spending makes up the large majority, or 65%, of OOP costs associated with pregnancy and birth, and that it’s been growing over the past few years.

While the average cost of pregnancy and birth has also risen, from $21,070 in 2016 to $22,000 in 2018, the HPC found that patients are paying for a larger share of those costs.

Average OOP costs increased from 5.3% of the total cost of pregnancy and birth in 2016 to 6.3% of the total cost in 2018. This caused the average OOP cost of pregnancy and birth to rise from $1,119 2016 to $1,372 in 2018.

But within OOP costs, it is deductible spending that is ballooning. From 2016 to 2018, mean spending on deductibles for pregnancy and birth costs increased by 25%, the HPC found.

“Deductibles not only are the largest piece, but they’re by far growing the most quickly,” senior researcher Sasha Albert said. “Copays and coinsurance did increase over these three years, but not by as much.”

The reason deductible spending is increasing, the HPC found, is due to more people enrolling in healthcare plans with high deductibles, which cost less money per month, but allow for more OOP costs before your insurance covers healthcare costs.

As of 2022, the IRS defines a high deductible health insurance plan as any health insurance plan with a deductible of at least $1,400 for an individual or $2,800 for a family.

As of 2019, 85% of commercially-insured Massachusetts residents with non-group coverage, and over 60% of commercially-insured residents employed at small- and medium-sized companies had health insurance plans with high deductibles, the HPC said.

“The population in general who is having babies is more likely to be younger and healthier and not have used up as much of their deductibles in a given year on other costs. So a lot of it will end up being spent on [pregnancy and birth],” Albert said.

The HPC also found…