A New Jersey Congresswoman is proposing to make pregnancy an open enrollment event where people can either switch insurance or go on the Exchange and get insured outside of the normal open enrollment period. I think covering pregnancy, pre-natal care, and post-partum care is an important policy objective but using the open enrollment system is not an optimal way of doing so.
We can start with a simple, commonsense improvement: making sure that mothers are given every opportunity to offer their babies a healthy start. That means offering women the opportunity to sign up for health insurance the moment that they find out they’re pregnant, getting the prenatal care they need.
Right now, events like the birth or adoption of a child, marriage, divorce, or even moving to a new state all trigger a special, 60-day window allowing individuals to enroll in a new health insurance plan. Yet pregnancy, one of the most life altering events anyone can experience, isn’t included on that list.
Special Enrollment Periods/qualifying events for people who have already identified that they are high cost individuals is a tough thing to square in a risk based insurance model. The better approach is to make Medicaid the payer of second resort for all pregnancy care while paying Medicare rates for those services.
Why is this?