Seeking clarity on racial disparities, Democrats ask insurers about maternal health coverage

More than 30 senators and representatives asked 15 major insurers last week about the pregnancy and postpartum services they cover as part of an effort to reduce racial disparities in maternal health.

The effort was led by a trio of Democratic Illinois lawmakers: Sens. Dick Durbin and Tammy Duckworth, along with Rep. Robin Kelly. The group sent letters to the nation's largest health insurance companies, including Aetna, UnitedHealthcare, Humana, Cigna, Anthem, Centene and Kaiser Permanente. 

The letters (PDF), signed by 23 senators and 11 representatives, noted that the maternal mortality rate in the U.S. is higher now than it was a quarter century ago, and black women are three-to-four times more likely than white women to die from pregnancy-related causes.

There is "a greater racial gap in infant mortality rates today than there was during slavery in America," the group wrote. Black infants are more than twice as likely to die before their first birthday compared to white infants, a statistic that is "simultaneously unacceptable and heart-breaking," the group wrote.

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"If 60% of pregnancy-related deaths in the U.S. are preventable, why are they not being prevented?" the lawmakers wrote, citing a report by nine maternal mortality review committees (PDF).

A 2016 report by the New York City Department of Health (PDF) found the maternal mortality rate was higher among Black women who graduated from college and lived in wealthier neighborhoods than it was among women of other races who did not graduate from high school and lived in very poor neighborhoods.  

Among the eight questions lawmakers posed to the insurers were inquiries into what steps the companies were taking to reduce racial disparities, what clinical guidelines they use to make coverage decisions and—citing concerns about an Affordable Care Act repeal—whether the insurers covered maternity and newborn care prior to the ACA's essential health benefits requirement.