It’s no secret that childbirth in American can come with a hefty price tag—even for those with private insurance. But, according to one new study, some families might spend as much as $10,000 out-of-pocket.
A new study published in the journal Pediatrics shows that from 2016 through 2019, privately insured families paid an average of $3,000 out-of-pocket for maternal and newborn hospitalizations. Plus, one in six families paid more than $5,000 out-of-pocket, and, for childbirths that required neonatal intensive care (around one in 11 families), the price soared to more than $10,000.
“Childbirth is the most common reason for hospitalization in the U.S. Our findings show that some privately insured families are shouldering an astoundingly high financial burden for childbirth-related hospitalizations,” 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 said in a statement. “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. 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.”
The researchers looked at national data of 12 million privately insured enrollees across all states in the country. They found 398,410 maternal deliveries that were linked to at least one newborn hospitalization covered by the same family plan. Overall, the average out-of-pocket spend for delivery and newborn hospitalizations was $$3,068. For c-section births, the average bill was $3,389. When NICU care was necessary, the average bill was $4,969, and for 9 percent of cases involving NICU care the bill exceeded $10,000.
According to the study, around 30 percent of the time, deliveries and newborn hospitalizations are covered by high-deductible health plans, like a health reimbursement arrangement or health savings account. Out-of-pocket costs were largely due to deductibles and coinsurance.
For Chua, the inspiration for the study is personal, as he paid a $5,000 out-of-pocket bill after 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, MD, MSc, FACOG, an obstetrician gynecologist at University of Michigan Health Von Voigtlander Women’s Hospital, childbirth is a necessary and high value service, so there need to be better policies to help lessen the financial burden of childbirth on families. Her hope is that insurers would waive most or all cost-sharing for these hospitalizations.
“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.”