Health Reform: Should maternity care and pediatric coverage be considered “essential benefits” for women and men over 55 years old?

Now that health care reform, often called “Obamacare” will be implemented, one key question focuses on what is covered.  The Department of Health and Human Services (HHS) has recently released a list of “essential benefits”, that is, what must be covered by all plans in order to allow consumers to make fair comparisons.

The list is broken down into 10 categories, one of them being maternity coverage and another being pediatric coverage.

For women and men over 55, this might seem unreasonable.  And we are not just talking about the care that first comes to mind- should complications arise, maternity care brings with it care in a neonatal intensive care unit (NICU), the costs of a perinatologist and the costs of a neonatologist, all of which can be very, very expensive.

Then we get to pediatric coverage, which covers care over an 18 year time horizon, also very expensive.

For those over 55, the decision to have a child is exceedingly remote, if not impossible. And this is not a gender issue- it affects both women and men, and turns the concept of health insurance into one of health care subsidies.  One option is that maternity coverage and pediatric coverage be available as a “rider”, meaning available at an additional cost to those who want it.

So here is the question- should people over 55 be required to purchase maternity coverage? And by extension, should childless adults be required to purchase pediatric coverage?  What do you think?

Health Reform: Should maternity care and pediatric coverage be considered an "essential benefit" for women and men over 55 years old?

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