BALTIMORE — A study from the University of Maryland School of Public Health and Harvard T.H. Chan School of Public Health is shedding light on disparities in maternity care spending across racial and ethnic groups.
The research, led by Rebecca Gourevitch—assistant professor at the University of Maryland College Park—examined over 87,000 pregnancies covered by private insurance. The study looked at costs from the start of pregnancy through six weeks postpartum.
“I’ve done work for a while about the impact of spending during childbirth and how that factors into people’s experiences,” said Gourevitch. “But there wasn’t any evidence on how that amount of spending varied across groups.”
The findings show Black and Hispanic mothers are paying significantly more out-of-pocket than white parents. For prenatal care alone, Black patients paid an average of 74% more.
“People from different racial and ethnic groups have really different experiences with the healthcare system in the U.S.,” Gourevitch said. “But the magnitude of the differences between the groups really surprised me and is definitely a concern.”
The disparities appear to be tied to the types of insurance plans patients are enrolled in.
“Patients who are Black or Hispanic are more likely to be enrolled in health plans that are less generous plans that leave them on the hook for higher out-of-pocket costs,” she explained.
The concern is that high costs could lead to patients skipping essential care.
“If people are facing high costs, it means they may skip out on some services that they might need—services that are important for their health or for their babies,” said Gourevitch.
The financial burden doesn't end after childbirth. She adds 50% of patients are still paying off medical bills a year after giving birth.
“When you add this on top of historical differences in income, wealth, and debt across racial and ethnic groups, I think that’s a serious reason for concern,” said Gourevitch.
Maryland lawmakers have previously considered legislation that would eliminate out-of-pocket costs for childbirth.
“But the measure has not yet passed. Researchers say policies like this could be an important step in addressing these disparities,” said Gourevitch.