There are significant differences in the out-of-pocket spending for maternity care by race and ethnicity, according to a new study published by JAMA Health Forum.
The study found that Black and Hispanic people have higher out-of-pocket costs for maternity health care, spending $2,398 and $2,300, respectively, compared to Asian and white people, who spend $2,202 and $2,036, respectively.
This is a 17.7 percent increase in spending for Black people, a 12.9 percent increase in spending for Hispanic people, and an 8.1 percent increase in spending for Asian people compared to white people.
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Using data from Blue Cross Blue Shield of Massachusetts, from January 2018 through December 2022, for pregnancies, deliveries, and 42-day postpartum care, the study included 76,826 birthing people with commercial insurance.
Additional findings include:
- During the prenatal period, Black people spent 32.6 percent more and Hispanic people spent 16.9 percent more on all care than white people. Asian people spent 6.3 percent less.
- For recommended prenatal care services, Black people spent 74.4 percent more and Hispanic people spent 51.2 percent more than white people.
- The greatest differences in out-of-pocket spending were in coinsurance payments.
- Coinsurance payments for maternity episodes were highest among Hispanic ($779), Black ($772), and Asian ($669) people compared to white people ($511).
- Enrollment in plans with high inpatient coinsurance was more likely among Black people (30.1 percent) and Hispanic people (33.5 percent) than Asian (18.3 percent) and white (18.4 percent) people.
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“These out-of-pocket spending differences are another way in which people of different races and ethnicities differentially experience maternity care in the US,” wrote the researchers, noting that changes to benefit design, especially coinsurance levels, could address these disparities in spending across racial and ethnic groups.
“To the extent that exposure to high out-of-pocket costs can impact maternal health, these health insurance benefit design changes could offer a pathway to improving health equity,” researchers added.