| Abstract: | The costs of prenatal care and the delivery of newborns are continuously increasing. In the 3 years since 1982 alone, the cost of a hospital delivery has increased approximately 40%. 40% of all births in the US are to women aged 18-24. These women compose the highest risk group for having complications of pregnancy. It is alarming that in 1984 more than 25% of these women had no form of insurance to cover the costs. Poor, minority, and unemployed women are most likely to lack coverage. The 3 basic types of coverage are individual or direct, employer's or indirect, and federal. Direct insurance is not always affordable and often provides incomplete coverage. Employer's insurance is often able to cover the costs of maternity care for many young women. However, a high rate of job turnover and the loss of a husband due to death or divorce excludes teenagers, widows, and divorcees from maintaining this type of indirect insurance. Federal insurance in the form of Medicaid has strict eligibility requirements. In nearly 1/2 the states one must be below the poverty level in order to be eligible, and the benefits vary among the states. In addition, many practitioners will not accept Medicaid as payment. The Aid to Families With Dependent Children is available in lieu of Medicaid, but only to single mothers who already have dependent children. The Maternal Child Health block grant is designed to equalize the differences in Medicaid eligibility among states and to give coverage to poor women who are ineligible for Medicaid. The individual states are allowed to allot the monies for this grant without qualifications for minimum services, with the result that it is unknown which women receive necessary services. |
