Q. Now that all kinds of health insurance must cover maternity care starting in 2014, will the plans also have to pay for midwives and deliveries in birthing centers?
A. Midwives, probably. Birthing centers, maybe.
Right now, "private insurance policies vary with regard to coverage of the services of a midwife," says Damaris Hay, a media relations specialist with the American College of Nurse-Midwives, the major midwifery professional organization.
That will change come 2014, because as of that date health plans may no longer discriminate against different types of health providers who are practicing in line with their professional licensing. What this means is that health plans will no longer be allowed to contract only with obstetricians to deliver maternity services. They'll have to offer network participation to midwives on the same terms as doctors as long as they are appropriately licensed, which they are in every state. (Read more about midwives and other alternative providers in our new report, The Nurse Practitioner Will See You Now.)
So come this fall, if you're shopping for a new plan on your state's Marketplace, check to see if midwives are on the provider list for maternity care.
As for coverage of childbirth outside of a regular hospital, that's up to each individual state. Forty-one states currently license birth centers, according to this map from the American Association of Birth Centers. This group also says that many insurance plans cover birth center deliveries. So if you're interested in one, again the thing to do is check with the plans you're considering this fall.
If you are or will be covered by Medicaid, you should know that the Affordable Care Act already requires all state Medicaid plans to cover midwifery services, and also pay for delivery in freestanding birth centers in states where they are licensed. And see what else the Affordable Care Act means for pregnant women and new moms.