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Birthing centers not provided for under health care reform

By Catholic Online (NEWS CONSORTIUM)
March 5th, 2014
Catholic Online (www.catholic.org)

Birthing centers have become an alternative for many couples expecting children. These centers are staffed by midwives, and eschew drugs to induce labor and monitoring the fetus with electronic equipment. However -- there are no coverage guarantees under health car reform to provide for these centers, in spite of the law's forbidding insurers against discriminating against licensed medical providers.

LOS ANGELES, CA (Catholic Online) - While the majority of women in the United States gives birth in hospitals and is attended by obstetricians, there is a growing number of those who choose to deliver their babies at birthing centers.

In 2012, 53,635 births in the United States took place outside the hospital, or 1.36 percent of all births. According to a study by the Centers for Disease Control and Prevention, 29 percent, or 15,577 births occurred at freestanding birthing centers, with the remainder primarily home births.

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While this represents a small percentage, the proportion of births at these centers increased 70 percent between 2004 and 2012, the CDC report found.

Medicaid is required to cover the services of licensed freestanding birth centers. Coverage of midwifery services had earlier been by federal law.

"Birth centers and certified nurse-midwives have a good record of safety and patient satisfaction and birth outcomes," Cynthia Pelligrini says, senior vice president for public policy and government affairs at the March of Dimes.

Birth centers are also significantly less expensive than hospitals. The average hospital charge for birth without complications was $10,166 in 2010, compared to $2,277 for a birth center.

Coverage of birth centers in private insurance plans, some experts say will become routine now that Medicaid, which pays for roughly 50 percent of all births in the U.S., has embraced their use. However -- coverage for birth centers and for midwives, who work in a variety of settings, including hospitals, is less predictable in private insurance plans.

Under the health law, maternity and newborn care is one of the 10 essential health benefits that must be covered in individual and small group plans unless they have grandfathered status.

Starting this year, health plans are prohibited from discriminating against licensed or certified health care providers who want to participate in their networks. At the same time -- insurers aren't required to contract with any particular provider.

Midwifery and birth center advocates say they're uncertain how the nondiscrimination provisions will be applied or enforced.

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