Should private insurance companies be required to cover the cost of prenatal care, deliveries, and after care from a licensed midwife? This is the question currently being debated by lawmakers in Vermont. The Senate in Vermont has passed this bill. Now, it is up to the House of Representatives in Vermont to vote on it.
Since the year 2000, the State of Vermont has been licensing midwives who are not nurses. It is perfectly legal for couples in Vermont to seek the services of a licensed midwife, instead of choosing a hospital to give birth in. However, not all private insurance companies will cover the costs of using a midwife, even if that particular insurance policy includes coverage for prenatal care.
There are many advantages of using a midwife instead of giving birth at a hospital. One obvious advantage is the cost. Regulators in Vermont identified the cost of a vaginal birth at a hospital to be around $6,803, (assuming the birth had absolutely no complications). This price does not include the cost of prenatal care, or the cost of physician charges.
A licensed midwife named Mary Lawlor, who has been delivering babies since 1981, said her fee was $3,500. This does include the cost of prenatal care, post birth visits, and the delivery itself. She would charge an additional $400 for the trained assistant, or for the second midwife, that was also present at the birth. Even with the $400 charge, using a midwife is still significantly less expensive than giving birth in a hospital.
People who live in Vermont and are considered to be “low-income” are using state health insurance programs. Since 2002, those programs have covered home births with midwives. However, people who live in Vermont and can afford to purchase private health insurance end up paying the entire cost of a home birth themselves, out of pocket, with no assistance from their insurance company.
If the Vermont House of Representatives passes this bill, it would require all private insurance policies to cover the costs of services from a midwife. Those that support the bill feel that this requirement fits right in with the goals of health care reform. A spokesperson from Blue Cross Blue Shield of Vermont felt that the bill would not significantly increase the cost of insurance for everyone.
Other insurance companies are unhappy about including another requirement in the same year that insurers are already having to deal with so many new health care laws. They point out that the current health care reform initiative was designed to cut costs. The implication is that those insurance companies feel that covering the cost of midwife services would raise their costs.
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