Baby Steps: SEIU 32BJ Joint Health Fund and Homebirth Struggle comes to a Successful (sort of) Close

Thanks to everyone for your support of a local mother who was denied health insurance coverage for her preferred method of birth—a home birth.  Together we were able to influence SEIU to change their reimbursement policy and cover out-of-hospital birth.

The birth community, loyal activists, outraged mothers, and Choices in Childbirth joined together to raise this woman’s voice in unison with ours, demonstrating national support for this type of insurance coverage. After several appeals and meetings (and meetings, and meetings), the SEIU 32BJ Joint Health Fund agreed to amend its policy and provide coverage for out of hospital births…. So why is this only a “sort of” success?

The problem is that the policy change only provided coverage up to the amount that they would pay for an in-network hospital provider fee (around $3,000), but the cost of a home birth in our area costs closer to $6000 in total.  Why is there a discrepancy in the prices - especially when advocates of homebirth often cite lower costs as one of the benefits? While the insurance company technically only pays out the roughly $3,000 for the provider fee, the total cost of the hospital birth is substantially higher and includes additional fees such as the “facility fee” (for use of the hospital, the tools, the nursing staff, the linens, etc.).  A homebirth midwife, on the other hand, brings the “facility” to you so to speak, not to mention that she spends personalized, one-on-one time with the laboring mother for the duration of the labor compared to the short amount of time the OB is usually present to deliver the baby.  This $6,000 fee incorporates the facility aspect, but without a “facility” the homebirth midwife is unable to collect those additional fees.

So while this local mom and her supporters were successful in getting the policy changed, the option turned out to still be un-accessible; Homebirths are now technically an option with this plan, but only if you can afford to pay the difference out of pocket.  (The woman gave birth to a healthy baby boy last week, by the way!)

I’d love to hear your thoughts… do you think that the insurance plan should pay for the full rate of an out-of-hospital rate? Do you have a story to share about out-of-hospital birth?  Do you think more women would opt for an out-of-hospital birth if they knew that it would be covered by their insurance? Check out our Facebook page and leave a comment on our wall!