According to the National Institutes of Health, As Many As 26 Percent of Pregnancies End in Miscarriage & More Than 24,000 Babies are Stillborn Each Year in the United States

WASHINGTON, D.C. — U.S. Representatives Abigail Spanberger (D-VA-07) and Mariannette Miller-Meeks (R-IA-01) today — during Pregnancy and Infant Loss Awareness Month — introduced bipartisan legislation to make sure that women who experience miscarriage or stillbirth are not charged more for the prenatal care they received before losing their pregnancy than they would have been if they had been able to carry to live birth.

As many as 26 percent of all pregnancies end in miscarriage, according to the National Institutes of Health (NIH). Additionally, more than 24,000 babies are stillborn in the United States each year — affecting about one in 160 pregnancies at 20 weeks or later. Combined, pregnancy loss affects nearly one million expecting mothers in the United States each year.

Many insurers bundle services needed by expecting mothers — such as prenatal visits, ultrasounds, labor and delivery, a postnatal checkup, and newborn care — under one single copayment. Bundled payments — also known as episode-based payments — are a type of alternative payment model created to improve patient outcomes by encouraging providers to move away from a fee-for-service model which reinforces volume-driven healthcare and instead toward a value-based payment model which motivates providers to coordinate care. However, many episodic payments retroactively revert to separate, fee-for-service payments in the event of an incomplete “episode” — such as a miscarriage or stillbirth — and cause women to instead owe separate copays for each service previously received. This unfortunately results in a much costlier sum of medical bills than these grieving families would have been charged for the single bundled copayment they were expecting for the pregnancy otherwise.

Spanberger’s bipartisan Caring for Grieving Families Act would limit cost-sharing for prenatal care provided in pregnancy bundles if a woman experiences a miscarriage or stillbirth to ensure parity with copayments for pregnancies that are carried to term. Specifically, the legislation would prohibit group health plans or individual health insurance plans that cover pregnancy-related services in a bundled payment from imposing any cost-sharing requirement — including deductibles, coinsurance, and copayments — on prenatal services provided prior to pregnancy loss in an amount that is higher than the cost would have been for the bundled payment if the miscarriage or stillbirth had not occurred.

“Each year, hundreds of thousands of women in Virginia and across our country experience the heartbreaking loss of a pregnancy due to a miscarriage or stillbirth. These women and their families — who are already mourning a devastating loss — should not be subsequently burdened with higher-than-expected medical bills for a pregnancy they are no longer carrying,” said Spanberger. “Our bipartisan Caring for Grieving Families Act offers a straightforward solution to a cruel problem and would make sure that no grieving family is penalized for losing a pregnancy to no fault of their own.”

Spanberger introduced the bipartisan legislation alongside U.S. Representative Mariannette Miller-Meeks, a member of the Maternity Care Caucus and physician.

“Enduring the loss of a pregnancy is a shattering experience for expecting mothers and their families,” said Miller-Meeks, M.D. “The Caring for Grieving Families Act ensures that mothers who suffer a miscarriage or stillbirth are not subject to a higher medical bill. This legislation would streamline pregnancy care payments and avoid adding financial burdens to women who experience either a miscarriage or a stillbirth.”

The bipartisan Caring for Grieving Families Act is endorsed by March of Dimes, the American College of Obstetricians & Gynecologists (ACOG), Birth in Color RVA, the National Partnership for Women and Families, Mom Congress, Planned Parenthood, and the National Health Law Program.

“Pregnancy is a joyous time for most expecting couples, but unfortunately, things don’t always go to plan. Experiencing a miscarriage or stillbirth is devastating and parents should be able to mourn the loss of their child without ending up with higher-than-expected medical bills for services they incurred leading up to their loss. Insurers are engaging in predatory actions by retroactively un-bundling prenatal services that tens of thousands of families depend on,” said Stacey Brayboy, Senior Vice President, Public Policy & Government Affairs, March of Dimes. Thank you to Representatives Abigail Spanberger and Mariannette Miller-Meeks for protecting and supporting these grieving families through the Caring for Grieving Families Act.”

“The unanticipated loss of a pregnancy is already a heavy burden on the parent and the family. It comes with a heavy emotional and physical toll and our current social safety net systems offers few if any supports post miscarriage and stillbirth. It is unconscionable to think that insurance companies would place additional burdens on the already grieving parents by retroactively changing their coverage from bundled or episodic payments to fee-for-service payments, increasing the financial burdens on families going through tragedy,” said Kenda Sutton-EL, Executive Director, Birth In Color RVA. “We at Birth In Color RVA fully support ensuring that pregnant persons who go through a miscarriage or stillbirth are not penalized for their loss! Women of color, black women in particular, suffer disproportionately from pregnancy loss, and, as with so many other areas of disparity, marginalized populations are disproportionately affected and are often least able to absorb additional costs and burdens. A lot has yet to be done to ensure that miscarriage and stillbirth survivors are taken care of in our society the way they should be – this bill is an important step in the right direction.”

“21,000 stillbirths are experienced in the United States annually, and more than 30% of all U.S. pregnancies end in miscarriage. The Caring for Grieving Families Act will ensure that no family will endure further unexpected hardship by being charged higher copays or coinsurance for prenatal care they had already received, than if their pregnancy did not end in miscarriage or stillbirth,” said Joy Burkhard, Founder, 2020 Mom and Mom Congress. “Mom Congress applauds this critical step forward in recognizing the importance of supporting every single US pregnancy.” 

Click here for bill text.

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