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Maternity Leave and Obamacare

Daniel Walker
Licensed Insurance Agent for 15 Years

UPDATED: Mar 19, 2020

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The lowdown...
  • Maternity care itself is now considered to be an essential benefit under Obamacare, meaning that every woman with insurance must has maternity care covered
  • There is not a specific provision under Obamacare covering maternity leave and what it means to pregnant workers today
  • Maternity leave in the United States is still governed under the Family and Medical Leave Act of 1993
  • Up to 12 weeks of unpaid leave every year is granted to mothers of newborn children or newly adopted sons or daughters
  • No wage compensation is guaranteed for maternity leave

These are some of the basics that are helpful to know when discussing maternity leave, but there is much more to it than this. The ensuing sections will go into this topic on a much deeper level.

The Basics of Maternity Care Under Obamacare


Under the Affordable Care Act, all citizens and legal residents of the United States are required to obtain basic health insurance. These factors impact pregnant women in numerous ways. There are a series of new benefits under this era of health care that directly impacts mothers to be and children.

The goal is to give everyone, including those who are pregnant, access to quality preventative care services. This includes the following:

  • Support for lactation
  • Counseling services
  • Breastfeeding equipment

The type of universal health care coverage offered to Americans under Obamacare gives women access to much more than they would otherwise have, even if it does not directly address the issue of maternity leave. There are certain mandates and subsides now available that are designed to make health insurance more affordable.

There are certain mandates and subsides now available that are designed to make health insurance more affordable.

There are also a set of minimum standards that must be met by every insurance policy sold in America, which directly impacts expectant mothers.

Enter your zip code above to compare pregnancy health insurance quotes for free!

Health Coverage for Pregnant Women


If you are pregnant or planning to get pregnant, Obamacare has many services and benefits now available to you. It is also important to note that becoming pregnant and having a baby does qualify as a special life event. This means that you can obtain a health insurance plan from the Marketplace even when outside the open enrollment period.

As preexisting conditions are no longer being permitted to be excluded under Obamacare, women are afforded protection no matter what time of year they get pregnant and give birth.

When considering maternity leave, parents have a lot to take under advisement when looking at health coverage for their new baby. If you are not happy with your current coverage, or you need to obtain health insurance in the first place, you are able to do so.

You can either keep the plan you currently have or change plans altogether. Consider the following four key points as you study private health plans and their coverage for pregnancy-related expenses.

1. Benefits and Obamacare

Under Obamacare, you are to receive certain basic services both before and after the child is born. This is a part of the essential health benefits component of the Affordable Care Act. Every qualified plan within and out of the Marketplace are now required to cover them.

2. Pregnancy Doesn’t Disqualify You from Enrollment

Under Obamacare, it does not matter if you became pregnant prior to obtaining insurance coverage. Under the current health care provisions, this is a pre-existing condition and all such conditions are required to be covered no matter who you purchase your insurance through.

3. You are Entitled to a Summary of Benefits

No matter if you purchase your insurance within the Health Insurance Marketplace or outside of it with a private provider, your insurance company must provide you with a Summary of Benefits and Coverage.

This is a document that will detail exactly how your plan will cover the expenses associated with childbirth. It is useful to use this document as you compare policies that you think will be best suited to your needs.

4. Grandfathered Plans are an Exception to the Affordable Care Act Law

Do note that there are still some private individual health plans that are grandfathered under Obamacare, meaning that they are not necessarily obligated to cover pregnancy and childbirth. If you have such a plan, you will want to contact them to see which benefits you have as an expectant mother.

If you are not pleased with the response that you get, you are more than welcome to ditch that policy and purchase a new one outside of the open enrollment period and without penalty.

Medicaid and CHIP Under Obamacare


Millions of low-income Americans now qualify for Medicaid health insurance under Obamacare. This is great news for women who are pregnant and are in this demographic group. If you live in a state that offers Medicaid, maternity care and childbirth services are covered for individuals that fall below a certain income level.

Medicaid and CHIP can be applied for at any time of the year by either going through your state agency or the Insurance Marketplace.

Gender Bias is a Thing of the Past with Obamacare


One of the major provisions of Obamacare is that women and men are no longer treated differently for insurance purposes. In the past, women would pay higher premiums and often be denied coverage under the scope of some insurance policies. That is no longer the case, as gender rating is now forbidden, as are exclusionary policies based on preexisting conditions.

So, the savings will be noticeable to women about to go on maternity leave. It is also helpful to note that Obamacare requires insurance companies to provide folic acid supplements and breast pumps to women.

In Conclusion…


While maternity leave is not specifically mentioned under the provisions of Obamacare, women should be pleased overall with the level of care they will receive before and after pregnancy.

Given the new reality of mandatory insurance, many more expectant mothers will receive the prenatal care that they need. No longer will they have to worry about how to pay for C-sections and breastfeeding pumps, among other items.

The goal is to make these essential health benefits the new reality, leading to a healthy America overall. Compare policies today and determine which one provides you with the services and care that you need in your situation.

Enter your zip code below to find maternity health insurance that can take care of you now and long after your baby arrives! Our system is fast, easy, and best of all, free!

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