New York Health Exchange Set To Recognize Pregnancy As “Life Qualifying Event” For Enrollment

Women who become pregnant will be eligible to enroll in insurance plans from NY State of Health.

For residents of New York, getting health insurance as a pregnant woman is on track to becoming easier after the state legislature passed last week a first-of-its-kind bill changing how pregnancy would be classified at the state’s health insurance exchange.

The legislation will classify pregnancy as a “qualifying life event;” once the open enrollment periods to purchase health insurance under the Affordable Care Act (often called Obamacare) end each year, only people who experience these events—getting married, having a baby or adopting a child, losing health coverage, among others—are still eligible to enroll. Becoming pregnant originally did not make the cut.

Now, if Governor Andrew Cuomo signs the legislation, New York will become the first state to make that addition. If signed into law, it will allow NY State of Health, New York’s healthcare exchange, to accept applications from women who are uninsured, underinsured, or who don’t qualify for Medicaid to purchase health insurance once they become pregnant. It will provide New York’s moms-to-be with access to vital prenatal care, which is important for both mother and baby.

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“Ending prematurity, premature birth, birth defects, and infant mortality in New York State could realize an annual savings of over $1 billion dollars,” said Caitlin Goss, state director of advocacy and government affairs for the New York State chapter of March of Dimes. “We know that prenatal care is one of the best ways to help mom have the healthiest pregnancy, and thereby the healthiest baby possible. And so, by making this initial investment, we’re confident that we’re going to the see the number of poor birth outcomes, as well as the number of premature births, decrease, which will in turn decrease the utilization of health care services.”

According to March of Dimes, the average medical cost for a healthy baby is less than $5,000, while the average medical cost for a premature baby is more than $55,000.

“New York State is providing a model for the nation in establishing a special enrollment period for pregnancy,” said March of Dimes Senior Vice President for Public Policy and Government Affairs Cynthia Pellegrini in a press release. “The March of Dimes urges every state to follow New York’s lead in ensuring that all pregnant women have access to affordable, quality health insurance.”

March of Dimes commended Westchester and Hudson Valley Assemblymen Gary Pretlow, Thomas Abinanti, Steven Otis, Kieran Michael Lalor, and James Skoufis, and State Senators George Latimer, Andrea Stewart-Cousins, and Sue Serino for their support of the legislation.

“A woman should not have to worry about the enrollment period of her health insurance plan when she becomes pregnant,” said Abinanti, who represents Greenburgh and Mount Pleasant. “It makes sense to reopen the enrollment time for her. Good prenatal care is vital to protecting the health of pregnant women and to ensure that they have healthy babies.”

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