Policy, Payers

In New York, pregnancy could be classified as a “qualifying event” for health insurance enrollment for the first time

New York could be the first state to add pregnancy to the list of qualifying life events that make one eligible for health insurance enrollment.

A new bill awaiting Democratic Gov. Andrew Cuomo’s signature in New York could make it the first state to classify pregnancy as a “qualifying event” for health insurance enrollment.

The bill was approved by both chambers of the state’s legislature last week. Currently under the Affordable Care Act, pregnancy does not make the list of qualifying life events that allow enrollment in employer-sponsored or state exchange insurance plans during time periods outside of open enrollment. Other life events that currently allow for enrollment include birth of a child, marriage, divorce, adoption, leaving incarceration and becoming a U.S. citizen.

The motivation for adding pregnancy to the list in the state gained momentum earlier this year when New York City Comptroller Scott Stringer issued a report pointing to the barriers to healthcare access for pregnant women. The report noted that for uninsured pregnant women, they could face up to $20,000 in out-of-pocket costs. This is particular relevant in New York considering that at 61 percent, it has the country’s second highest rate of unintended pregnancy.

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“The economic and health benefits of proper healthcare during pregnancy and in the early stages of a child’s life are well documented,” the report read. “A woman should not have to wait until her baby is born to receive the services she needs from our state’s insurance marketplace. Through this action, we will show our commitment to the health and wellbeing of mothers and their children, as well as the principle of access to healthcare for all.”

Although some businesses and insurers have concerns about broadening the list of qualifying life events, reproductive rights groups are supportive of the bill’s potential passing.

“Pregnancies are quite often unplanned, making limited enrollment periods impractical for many women,” Andrea Miller, the president of NARAL Pro-Choice New York, said in a statement. “This legislation is good for the health of all New York families, and NARAL Pro-Choice New York looks forward to working with Gov. Cuomo to ensure its compliance.”

She continued, “High prenatal costs increase the likelihood that uninsured women without the option to purchase insurance will simply forgo care, jeopardizing their health. This legislation will improve access to care, leading to healthier women and healthier children.”

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 Photo: Flickr user Sean Molin