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What Federal Health Care Reform Means for Families

Learn how health reform will impact maternity care in Pennsylvania

The Benefits to Maternal and Child Health

 
  • ensures women find comprehensive health insurance that covers maternity and mental health care by requiring all plans sold to individuals and small employers to cover these essential health benefits.
  • bans insurance companies from charging higher rates to women and denying coverage if a woman has had breast or cervical cancer, a Cesarean section delivery or received medical treatment for domestic violence.  
  • bans insurance companies from denying coverage to children because they have pre-existing conditions.
  • eliminates co-pays and deductibles for preventative care, like mammograms and pap smears.
  • decreases premiums and charges for prescription drugs.
  • allows parents to cover their kids up to age 26.
  • reduces each family's yearly insurance premiums by about $2,000.
  • women no longer need a referral to see an OBGYN.
  • taxpayers save $143 billion on medical spending over the next decade as projected by the Congressional Budget Office.
 
 
 
The Affordable Care Act (PL 111-148) and the Health Care and Education Reconciliation Act, otherwise known as 'Health Care Reform,' were signed into law on March 23, 2010.
 
Benefit
Description
 Effective

 

Breastfeeding

All employers must permit break time for women to breast pump and/or feed their infants.  For employers with 50 or less employees, they can opt out of this law if they can prove undue hardship.

You can read the The Department of Labor's factsheet outlining their regulations.

March 23, 2010

 

 

 

PA Fair Care

 

Pennsylvania’s health plan for uninsured adults with pre-existing conditions. This temporary plan offers transitional insurance coverage until the broader coverage provisions of federal health insurance reform become active in January 2014.

Pregnancy is considered a pre-existing condition eligible for coverage by this program.

Eligibility

  • Must have a pre-existing condition
  • Pennsylvanian resident
  • US citizen or national or lawfully present
  • Uninsured for at least 6 months prior to applying for coverage through this program

Subsidized premiums are $283.20 a month, plus additional co-pays and coinsurance. For info, visit www.pafaircare.com or call, toll-free, 1-888-767-7015. Enrollment is first-come, first-served.

August 4th, 2010

 

Home Visiting

Creates a state based home visiting program to serve higher risk families during pregnancy and the infant-toddler years.

PA applied and completed a needs assessment in Spring 2011.

PA received a planning grant and will distribute funds to 11 agencies in 9 counties, none in SEPA.

 

Maternal Depression

The Mother's Act provides $3 million to states to provide services to individuals with, or at risk, of postpartum depression and their families. The appropriation will also fund education and research for postpartum depression.

 

2010

 

Pregnancy Assistance Fund

Competitive grants for states to assist pregnant and parenting teens and women, including those who are victims of domestic violence.

PA did not receive any funds.

 

 

A Woman is Not a Pre-existing Condition: The National Women's Law Center

Changes to Insurance Plans

* Excludes pre-existing conditions for children.

* All private insurance plans will be required to offer a package of women’s preventive care and screening (Pap smears and mammograms) without requiring co-pays.

 

* Insurance companies will not be able to deny coverage for pre-existing conditions such as pregnancy, or prior cesarean section delivery.

* Insurance companies cannot charge higher premiums based on gender or health status. 

* All Health Plans will need to cover essential health benefits including maternity and newborn care and behavioral health treatment.

March 23, 2010

Effective Jan 1, 2011

 

Effective in 2014

 

Effective in 2014

 

Effective in 2014

 

 

Opportunities for Providers of Women's Healthcare

* State grants to promote community health teams’ service support to primary care practices will include obstetricians.

* Free standing Birth Centers and their licensed practitioners will be eligible for Medicaid reimbursement within 90 days.

*Certified Nurse-Midwives will receive equitable reimbursement.

* Increased funding for the education of all childbirth professionals.

Effective during the next 4 years

For more detailed information, read the analysis and summary of key provisions created by the Association of Maternal and Child Health Programs (or AMCHP).

Please send questions, corrections and comments to Director of Public Policy at Maternity Care Coalition.

 

Help Implement Health Care Reform in Pennsylvania

Stay up to date on policy issues important to maternal child health, including the implementation of federal health reform in Pennsylvania: Past Public Policy Alerts are available online.

 

Maternity Care Coalition collaborates with other organizations to implement health reform in Pennsylvania as part of the Raising Women's Voices coalition and the PA Health Access Network (PHAN). Check PHAN's website for upcoming conference calls on health reform in PA.

 

 

 

Last Updated February 2011

 


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Phone: 215.972.0700, Fax: 215.972.8266, : mcc@MOMobile.org