Even for those with private insurance, the cost of giving birth in America may come as a shock to many families.
According to a recent Michigan Medicine-led research, some families may pay as much as $10,000 out of pocket when birthing mothers require caesarians or their infants require neonatal care.
“Childbirth is the most common reason for hospitalization in the U.S.,” said lead author Kao-Ping Chua, M.D., Ph.D.,a pediatrician and researcher at University of Michigan Health C.S. Mott Children’s Hospital and the Susan B. Meister Child Health Evaluation and Research Center.
“Our findings show that some privately insured families are shouldering an astoundingly high financial burden for childbirth-related hospitalizations.”
According to a study published in Pediatrics, privately insured families paid an average of $3,000 out-of-pocket for maternal and infant hospitalizations between 2016 and 2019. Out-of-pocket spending topped $5,000 for one in every six households. When newborn critical care was necessary, the cost for roughly 1 in 11 families soared to above $10,000.
“Many privately insured families believe that if they have health insurance, they’re protected from the costs of childbirth hospitalizations. Unfortunately, this is simply not true for many families, particularly if their baby needs NICU care,” Chua said.
“Having a healthy baby is expensive enough given the costs of diapers, childcare, and baby equipment. Adding a $10,000 hospital bill on top of this can devastate some families.”
Researchers looked at national data from 12 million privately insured consumers from all 50 states. There were 398,410 maternal births connected to at least one neonatal hospitalization covered by the same family plan, according to the researchers. Overall, $3,068 was spent out of pocket for the birth and infant hospitalizations.
The average price for cesarean delivery was $3,389. The average price for NICU treatment was $4,969. In 9% of cases when NICU care was required, the expenditure surpassed $10,000.
High-deductible health plans, such as a health reimbursement agreement or a health savings account, funded around 30% of births and infant hospitalizations. Deductibles and co-insurance were the main drivers of out-of-pocket expenses.
Chua was motivated to conduct the research after his own personal experience with a $5,000 out-of-pocket expense following the birth of his second daughter.
“This is an issue that impacts millions of Americans at some stage in their lives,” he said.
“Before delivery, clinicians can help privately insured families understand their childbirth benefits. If large bills are expected, clinicians should advise families to save money, assuming they have the means to do so. After delivery, clinicians should screen families for financial hardship, particularly those experiencing resource-intensive hospitalizations, such as NICU care, and connect them with local resources to address food, housing, and financial insecurity.”
According to senior author Michelle Moniz, M.D., M.Sc., an obstetrician gynecologist at University of Michigan Health Von Voigtlander Women’s Hospital, while considerable cost-sharing may be acceptable for low-value treatment, delivery is a required, high-value service. According to Moniz, policy should strive to relieve families of the financial burden of childbearing.
In an ideal world, insurers would eliminate most or all cost-sharing for these hospitalizations, as Medicaid programs and many comparable, high-resource nations have done, she adds.
The new research complements Moniz’s prior work on the out-of-pocket expenses of pregnancy, birth, and postpartum care for women.
“Maternal and childbirth hospitalizations are essential to families’ health and wellbeing, with some babies needing longer stays because of complex or unexpected medical conditions,” Moniz said.
“These services are vital to ensuring the best possible outcomes for moms and newborns. We should be looking at ways to improve childbirth coverage to avoid sending families home from the hospital with thousands of dollars in debt.”