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Until 10 AM

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Affordable Care Act maternity coverage requirement causes controversy

Updated: Tuesday, November 12, 2013 |
Affordable Care Act maternity coverage requirement causes controversy story image
(NEWSCHANNEL 3) - The Affordable Care Act has been generating a lot of controversy because of the shaky roll-out of healthcare.gov.

But Monday, there's more controversy over one of the ten medical benefits that every insurance policy must include--maternity care.

Everybody must have it--young men, older women, everybody.

From the moment a woman gets pregnant, doctors say it's important that they get quality prenatal care.

That means checkups and nutrition to insure that the child comes into the world healthy.

"A lot of times, they show up late in the pregnancy with potential problems that we could have treated earlier," explained Dr. Robert Winter, with Borgess Women's Health.

Expectant mothers say it can give them peace of mind during a stressful time.

"To see the doctor to be sure that everything is okay is very important," said expectant mother Kale Balsor.

All that medical care can really add up, and now as part of the Affordable Care Act, every insurance policy must include maternity coverage, even if that benefit will never be used.

"Today, maternity coverage is a rider, but in tomorrow's world, in 2014, every single individual plan will have maternity benefits coverage," said Priority Health Chief Marketing Officer Joan Budden.

On Capitol Hill last week, lawmakers grilled Health and Human Services Secretary Kathleen Sebilius over that aspect of the law.

Of course, a man will never have a child, but insurance companies say making the cost mandatory for everyone lowers the cost.

"The reason for that is that when everybody shares in the cost of maternity, it's a very low cost per person, if you have just the people who are using the maternity, it's very expensive for them individually," Budden said.

The Obama administration argues unhealthy babies and mothers impose a public cost on everyone.

Infant mortality is often considered an important indicator of the health of a community, and health care providers say even if men aren't ever going to get pregnant, they still benefit when pregnant women are well cared for.

"It's very beneficial for the family to have coverage, not only for moms, but for the rest of the family as well, because they may not anticipate a problem; it's there if they need it," said Dr. Winter.

This is not the only way that the Affordable Care Act subsidizes the cost of health care.

For example, the plan relies on young people, who do not use much health care, to get coverage.

Their premiums will ultimately balance out the expenses of older people, who use the coverage more often.
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