Why aren't insurance companies more home birth friendly?

Ms Molly

I've seen many of you describe having to jump through hoops to get even part of your homebirth covered by insurance.  This got me thinking, why do insurance companies seem to discourage home births, when they generally cost them less?  I would think that less meds, edpidurals, and a reduced chance of a C-section would be something to encourage from a financial perspective. 

yeshuahamasshiah

LIABILITY ISSUES!!

A recent study published in AJOG states:

"Less medical intervention during planned home birth is associated with a tripling of the neonatal mortality rate."

 Unfortunately I do not have access to the full article, but you can read the abstract HERE

Fear of being sue make insurance companies go the safe route. IMO it would be easier and more effective if instead of having to pay for insurance and then having all kinds of expenses OOP, we just paid OOP and be done with it.

However the situation will just get worse with Obamacare passed. I am sure many have read/heard about how the state of Virginia is suing the Federal Gov't because Virginia "argues that Congress overstepped its constitutional authority with a provision mandating that Americans buy health insurance by 2014 or pay a fine." Let's see what comes of it!

HERE is a link to an article talking about the Virginia lawsuit, in case anyone is interested.

 

*LrCg*

My insurance company gave me no issues.  Their only requirement was that it was with a CNM.  None of their CNM would do a homebirth so I found my own and she filed an out of network exception.  The birth was covered 100%.  One thing I found odd was that they would cover a homebirth but not a birth center (my midwife has a center but also does homebirths) but that wasn't a big deal to me since I only wanted a homebirth.

mysticporter

I think it's a combination of factors.  As PP pointed out, there may be liability issues.  Also, in general most health insurance companies have preferred providers with whom they have negotiated contracts/fees, and there probably isn't enough call for them to do so with home birth attendants.  Being perfectly honest, it seems to me that it's the double-edged sword of the perspective many people who opt for a home birth have, that birth is a natural process as opposed to a medical procedure (health insurance is for medical procedures).

skyejo

I'm sure there's a lot of reasons but the first one that comes to mind is liability.  The American Medical Association opposes home birth since they believe it's unsafe so that has to raise a red flag to insurance companies.  Hell, my plan with BCBS doesn't even cover a MW! I had to go with a OB/MW practice so that my MW can bill everything under the OB so that it will be covered.  It's tragic how natural birth is treated as something wrong and dangerous.

pepomntpat

Mine covers home birth as long as it is attended by a licensed provider.  We've had other issues with our insurance so I was really surprised about their flexibility on this.

Mrs_Liberto

yeshuahamasshiah:

LIABILITY ISSUES!!

A recent study published in AJOG states:

"Less medical intervention during planned home birth is associated with a tripling of the neonatal mortality rate."

 Unfortunately I do not have access to the full article, but you can read the abstract HERE

Fear of being sue make insurance companies go the safe route. IMO it would be easier and more effective if instead of having to pay for insurance and then having all kinds of expenses OOP, we just paid OOP and be done with it.

However the situation will just get worse with Obamacare passed. I am sure many have read/heard about how the state of Virginia is suing the Federal Gov't because Virginia "argues that Congress overstepped its constitutional authority with a provision mandating that Americans buy health insurance by 2014 or pay a fine." Let's see what comes of it!

HERE is a link to an article talking about the Virginia lawsuit, in case anyone is interested.

 

Agreed on the liability issue.  BUT you are convoluting two very huge and very separate issues within the American medical system that really don't compare.

It is one issue to blame medical malpractice lawsuit caps (or lack thereof) and the skyrocketing costs associated with obstetric malpractice insurance.

Perhaps closely tied to that is the ability of health insurance companies to create their own standards of care under which an OB must operate--it effectively ties the hands of OBs who, if they want to get paid and actually be able to pay their own skyrocketing med-mal insurance, must comply with egregious demands of healthcare companies.

The constitutionality of the Affordable Healthcare Act is a completely separate debate, and frankly your baseless assertion that "Obamacare is going to make things worse!" doesn't really answer any question asked by the OP.

 

Kerianne1176

yeshuahamasshiah:

LIABILITY ISSUES!!

A recent study published in AJOG states:

"Less medical intervention during planned home birth is associated with a tripling of the neonatal mortality rate."

 Unfortunately I do not have access to the full article, but you can read the abstract HERE

Fear of being sue make insurance companies go the safe route. IMO it would be easier and more effective if instead of having to pay for insurance and then having all kinds of expenses OOP, we just paid OOP and be done with it.

However the situation will just get worse with Obamacare passed. I am sure many have read/heard about how the state of Virginia is suing the Federal Gov't because Virginia "argues that Congress overstepped its constitutional authority with a provision mandating that Americans buy health insurance by 2014 or pay a fine." Let's see what comes of it!

HERE is a link to an article talking about the Virginia lawsuit, in case anyone is interested.

 

From what I hear, Michelle Obama is deeply interested in Birth issues and Maternal Mortality.  Perhaps, if all of us here wrote a letter to her or to the president about our desire for more choice in childbirth including the right to homebirth, CPMs, and healthcare coverage for these issues, they may consider looking at it.  It might be a step in the right direction and these days contacting the president is easier than ever....one can simply go to his website https://www.whitehouse.gov/contact and let their concerns be known.  This is also possible through your state senators...I have done it...have you?  The only way to change things is to demand change at such a rate that you can no longer be ignored..   Get to it girls!

MrsTiara

Adding to the fray, has anyone actually read the healthcare bill?  I have read the parts that address women's healthcare and actually, it does provide for midwifery coverage.  So this will make things BETTER!  If I weren't so freakn' exhausted, I'd hunt down the passages.

d.cubed

Kerianne1176:

yeshuahamasshiah:

LIABILITY ISSUES!!

A recent study published in AJOG states:

"Less medical intervention during planned home birth is associated with a tripling of the neonatal mortality rate."

 Unfortunately I do not have access to the full article, but you can read the abstract HERE

Fear of being sue make insurance companies go the safe route. IMO it would be easier and more effective if instead of having to pay for insurance and then having all kinds of expenses OOP, we just paid OOP and be done with it.

However the situation will just get worse with Obamacare passed. I am sure many have read/heard about how the state of Virginia is suing the Federal Gov't because Virginia "argues that Congress overstepped its constitutional authority with a provision mandating that Americans buy health insurance by 2014 or pay a fine." Let's see what comes of it!

HERE is a link to an article talking about the Virginia lawsuit, in case anyone is interested.

 

From what I hear, Michelle Obama is deeply interested in Birth issues and Maternal Mortality.  Perhaps, if all of us here wrote a letter to her or to the president about our desire for more choice in childbirth including the right to homebirth, CPMs, and healthcare coverage for these issues, they may consider looking at it.  It might be a step in the right direction and these days contacting the president is easier than ever....one can simply go to his website https://www.whitehouse.gov/contact and let their concerns be known.  This is also possible through your state senators...I have done it...have you?  The only way to change things is to demand change at such a rate that you can no longer be ignored..   Get to it girls!

Excellent point!  I will get right on this!

My insurance says that it doesn't cover HB because ACOG - The American Congress of Obstetricians and Gynecologists - is officially against home birth.  They just do what the "experts in the field" suggest.  (Nice excuse, right?).  Anyway, of course ACOG is going to be against home birth - birth is their livelihood.  Why let others get a piece of their pie?

MamiMoore

I think liability is what we think of as people. But homebirths are actually less expensive than hospital births and safer. There's an idea that homebirths aren't as safe, but insurance premiums aren't based on ideas, they are based on facts and statistics.

One HUGE fact is that insurance companies are in bed with hospitals, drug companies, and doctors so it's an I scratch your back you scratch mine type thing IMO.

mysticporter

MamiMoore:

I think liability is what we think of as people. But homebirths are actually less expensive than hospital births and safer. There's an idea that homebirths aren't as safe, but insurance premiums aren't based on ideas, they are based on facts and statistics.

One HUGE fact is that insurance companies are in bed with hospitals, drug companies, and doctors so it's an I scratch your back you scratch mine type thing IMO.

Studies regarding home births are far from conclusive, even as far as low-risk pregnancies, but they are certainly not safer as far as high risk pregnancies.  That may be another factor why they aren't covered...if home birth is universally covered, and a high risk pregnancy has a tragic end, the insurance company could be sued.  Conversely, if they exclude coverage for some people based on conditions, they could also open themselves up to law suits as far as unfair/discriminatory policies.

longingtoholdher2010

I don't understand it either, my insurance won't cover a cent of it. We are paying completely out of our own pocket, and it's not to bad considering that we switched to a midwife in the 3rd trimester but it would still be nice if insurance would cover any little part at all. Me and my midwife were just discussing the other day why the insurance companies aren't all over home births? They are a fraction of the cost of a hospital birth which where I'm from can start at around 8,000 dollars. compared to a home birth that were I am from general runs around 2,200 dollars, thank God we are not having to pay that full price with no help from insurance. I can't imagine having a hospital birth and having to pay the full price.