03-03-2025
High maternity costs hit Black and Hispanic patients hardest: study
Black and Hispanic people paid more in out-of-pocket costs for maternal care than Asian and white people with the same commercial insurance, a new study published in JAMA Health Forum found.
Why it matters: Black mothers in the U.S. face a pregnancy-related death rate that is more than three times the rate for white mothers. About 80% of these deaths are preventable. The maternal mortality rate for Hispanic women is similar to that of white mothers but has surged in recent years.
The cost burdens of maternity care may exacerbate those significant racial disparities, the researchers say.
What they did: The study looked at pregnancy, delivery and postpartum care claims data from patients insured by Blue Cross Blue Shield of Massachusetts from 2018 through 2022.
Among nearly 77,000 unique enrollees who gave birth, almost 79% were white, roughly 10% were Asian, about 8% were Hispanic and about 4% were Black.
Blue Cross Blue Shield of Massachusetts undertook the research along with academics at the University of Maryland and Harvard to establish a baseline as they try to design solutions for more equitable care, co-author Mark Friedberg, senior vice president of performance measurement and improvement at Blue Cross, said in a news release.
What they found: Black enrollees spent an average of $2,398 in total out-of-pocket spending for maternity care, between their deductible, copayments and coinsurance — or the amount an enrollee pays after they've hit their deductible.
Hispanic enrollees paid $2,300, while Asian enrollees paid $2,202 and white enrollees $2,036, on average.
Zoom in: Cost differences were especially pronounced for prenatal care, with Black enrollees paying 74% more than white people, the researchers found. Prenatal care is important to help avoid complications during birth.
Levels of copayments were similar across all groups, and deductibles were slightly lower among Hispanic and white enrollees.
But coinsurance payments differed significantly.
Black enrollees paid an average of $772 for coinsurance and Hispanic enrollees paid an average of $779. Asian enrollees paid an average $669. White people paid an average of $511.
The bottom line: Reducing coinsurance rates could make maternity care more accessible and, in turn, reduce maternal health disparities in the U.S., the researchers write.
