A groundbreaking study published today in JAMA Health Forum has revealed significant disparities in out-of-pocket expenses for maternity care among different racial and ethnic groups. The research, conducted by scholars from the University of Maryland School of Public Health (UMD SPH) and Harvard T.H. Chan School of Public Health, examined over 87,000 cases of pregnancy, delivery, and postpartum care from 2018 to 2022. It found that Black, Hispanic, and Asian individuals with private insurance tend to incur higher personal costs compared to their white counterparts. This disparity is most pronounced during prenatal care, where Black individuals paid significantly more, highlighting another layer of inequality in maternal healthcare.

Study Details Reveal Stark Differences in Maternity Care Expenses

In a comprehensive analysis spanning five years, researchers scrutinized anonymized data from Blue Cross Blue Shield of Massachusetts (BCBSMA). They discovered that Black, Hispanic, and Asian individuals faced disproportionately higher out-of-pocket costs for maternity care services. Specifically, during prenatal care, Black individuals paid an average of 74% more, while Hispanic individuals paid 51% more, and Asian individuals paid 4% more than whites. These differences were less pronounced but still notable during delivery and postpartum periods.

The financial burden was particularly significant for Black and Hispanic families, as these costs represented a larger share of their household income. Dr. Rebecca Gourevitch, lead author of the study and assistant professor at UMD SPH, emphasized that these findings underscore the urgent need to address inequities in healthcare access and affordability. She noted that coinsurance rates—where patients pay a percentage of medical costs after meeting their deductibles—are a major driver of these disparities, especially for high-cost services like hospital deliveries.

Dr. Mark Friedberg, senior vice president of performance measurement and improvement at BCBSMA, highlighted the importance of this study in understanding the root causes of longstanding inequities in maternal health outcomes. The insights gained could inform policy changes aimed at making healthcare more equitable for all pregnant individuals.

Anna Sinaiko, senior author and associate professor at Harvard’s TH Chan School of Public Health, pointed out that eliminating out-of-pocket costs for maternity care, as proposed in some states, could have a substantial impact on reducing these disparities. Such policies would particularly benefit Black and Hispanic communities, who currently bear the highest costs.

The study's authors conclude that there is a clear opportunity for health insurance companies, employers, and policymakers to collaborate in designing more equitable health insurance plans that lower out-of-pocket expenses for pregnant and postpartum individuals.

This research underscores the critical role of systemic changes in addressing healthcare inequalities. By shedding light on these financial disparities, it calls for proactive measures to ensure that all individuals receive equitable and affordable maternal care, regardless of their racial or ethnic background.