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March 2, 2025 – A new study published in JAMA Health Forum has found significant racial and ethnic disparities in out-of-pocket spending for maternity care among individuals with private insurance. Black, Hispanic, and Asian individuals tend to pay more than white individuals for pregnancy, delivery, and postpartum care.
The study, conducted by researchers from the University of Maryland School of Public Health (UMD SPH) and the Harvard T.H. Chan School of Public Health, analyzed anonymized data from Blue Cross Blue Shield of Massachusetts (BCBSMA) spanning five years (2018–2022), covering over 87,000 pregnancies.
Key findings include:
- Pregnancy:
- Black individuals paid, on average, 74% more for recommended prenatal care services than white individuals.
- Hispanic individuals paid 51% more.
- Asian individuals paid 4% more.
- Delivery and Postpartum:
- While disparities were smaller than during pregnancy, Black and Hispanic individuals still faced significantly higher out-of-pocket costs.
- Overall Impact:
- Black and Hispanic individuals’ out-of-pocket costs represented a significantly higher proportion of their household income.
- 26.9% of the pregnancies analyzed were in areas with a median household income of $75,000 or less.
The study identified coinsurance rates as a major driver of these disparities. Black and Hispanic individuals are more likely to be enrolled in insurance plans with high coinsurance levels (above 10%).
“The average additional spending on medical care from pregnancy through postpartum paid by people who are Black, Hispanic and Asian is significantly more than white people,” said Dr. Rebecca Gourevitch, the study’s lead author. “The study shows yet another way that people from different racial and ethnic groups are having different experiences of maternity care. And the burden of greater out-of-pocket costs could have a real impact on maternal health.”
Researchers suggest that policy changes, such as eliminating out-of-pocket costs for maternity care, would significantly benefit Black and Hispanic individuals, who face the highest financial burdens.
“Our results reveal that health insurance companies, employers and policymakers have an opportunity to lower out-of-pocket costs for all pregnant and postpartum people and to reduce disparities in costs by changing how health insurance plans are designed,” said Gourevitch.
Disclaimer: This news article is based on information available at the time of publication and reflects the findings of a specific study. Healthcare costs and insurance policies are subject to change. This article is for informational purposes only and does not constitute medical or financial advice. Individuals with concerns about maternity care costs or insurance coverage should consult with their healthcare provider or insurance provider. The study was conducted using data from one insurance provider in one US state, therefore the results may not be generalizable to the whole US population.
