Health Insurers Consider A Caesarean-Section Pregnancy A Pre-Existing Condition

By Amanda Terkel Earlier this week, the Huffington Post’s Ryan Grim reported on the fact that in seven states plus the District of Columbia, “getting beaten up by your spouse is a pre-existing condition.” The insurance industry figures that if “you are in a marriage with someone who has beaten you in the past, you’re more likely to get beaten again than the average person and are therefore more expensive to insure,” but what it really does is punish these victims for something that wasn’t their fault.

But that isn’t the only policy that health insurers have that primarily discriminate against women. First of all, most individual health insurance markets don’t cover maternity care. In fact, according to the Kaiser Family Foundation, only 14 states have a requirement for such coverage, and the number of plans without maternity coverage continues to rise dramatically. Why? Anthem Blue Cross — which has been actively fighting health care reform — considers pregnancy optional and therefore not necessary to insure:

“The point of insurance is to insure against catastrophic care costs. That’s what you’re trying to aggregate and pool for such things as heart attacks and cancer,” said an Anthem Blue Cross spokesman. “Having a child is a matter of choice. Dealing with an adult onset illness, such as diabetes, heart disease breast or prostate cancer, is not a matter of choice.”

Even Louisiana Gov. Bobby Jindal (R) spoke an unintentional truth when he said of his parents: “When they arrived in Baton Rouge, my mother was already four-and-a-half-months pregnant. I was what folks in the insurance industry now call a pre-existing condition.”

When a woman isn’t currently pregnant, she often still cannot get coverage. Many insurers consider a Caesarean-section pregnancy a pre-existing condition and refuse to cover women who have had the procedure. From a 2008 New York Times story about a Colorado woman who had Golden Rule Insurance:

She was turned down because she had given birth by Caesarean section. Having the operation once increases the odds that it will be performed again, and if she became pregnant and needed another Caesarean, Golden Rule did not want to pay for it. A letter from the company explained that if she had been sterilized after the Caesarean, or if she were over 40 and had given birth two or more years before applying, she might have qualified.

The number of C-sections performed in the United States has been “growing steadily,” with approximately 30 percent of women having the procedure. Other insurance companies that don’t necessarily reject women with C-sections often do charge them higher premiums or “factor in chronic or recurring problems that might have led to the Caesarean.” What’s even worse is that once you’re denied by one company, it’s harder to get coverage somewhere else because you’ve been red-flagged.

Today, Golden Rule CEO Richard Collins is testifying before the House Subcommittee on Domestic Policy about “Bureaucracy of Private Health Insurance.”