Without coverage through work or on a partner's plan, expectant moms face paying exorbitant prices for necessary prenatal care and delivery procedures. The American Pregnancy Association (APA) estimates that the cost of delivery alone is $6,000-$8,000, and that's for a normal pregnancy. High-risk pregnancies and hospital stays can tack on thousands.
The APA estimates that approximately 13 percent of women who become pregnant each year are not insured, often resulting in inadequate prenatal care, which can lead to complications for the mother and child.
Her insurance classified it as a specialty tier drug, also known Tier 4. That means she pays 30 percent of the cost of the drug rather than a simple co-pay.
Specialty tier pricing started under Medicare Part D. Michelle Vogel is executive director of the Alliance for Plasma Therapies and has been tracking the impact.
"Whatever happens with Medicare typically follows in private insurance, so when I was looking at the private plans, and especially in California, you're seeing the majority of plans, have put in Tier 4 plans," said Vogel.
Ma is proposing legislation in California to prevent health insurers from moving vital medications to Tier 4 status.
"What we're trying to do is make ensure that patients are able to afford the medication they need.
Right now, New York is the only state with a law preventing specialty tiers. Ma plans to announce the specifics of her legislation on Thursday. However, state legislation does not impact self-funded health plans which cover about half of all employees with health insurance. Federal legislation is needed to change that.