Eliminating Out-of-Pocket Costs for Prenatal, Delivery, and Postpartum Care A Policy Recommendation for the Nevada Legislature

Eliminating Out-of-Pocket Costs for Prenatal, Delivery, and Postpartum Care A Policy Recommendation for the Nevada Legislature Nevada mothers face real and measurable financial harm. Childbirth in Nevada is associated with an average of nearly $2,100 in additional out-of-pocket spending for new mothers covered by private insurance. Roughly one third of multi-person households and half of single-person households lack the liquid assets needed to cover typical out-of-pocket costs associated with pregnancy and childbirth under private health plans. When a pregnancy crosses two calendar years, families may be required to satisfy two separate deductibles — dramatically increasing their financial exposure through no fault or choice of their own. The financial stress associated with childbirth costs does not stop at the medical bill. Medical debt reduces credit scores, limits access to rental housing, and can trigger collection actions including wage garnishment and foreclosure. Studies show that people carrying medical debt face a significantly higher risk of housing instability, and among those experiencing homelessness, medical debt is frequently cited as a contributing factor, with even modest amounts extending the duration of homelessness by years. The consequences are especially serious for pregnant women. Housing instability during pregnancy is associated with significantly higher rates of preterm labor, NICU admission, hypertensive disorders, anemia, and hemorrhage. The harm does not stop with the mother; research indicates that housing instability during pregnancy creates intergenerational risk, increasing the likelihood of homelessness for the child as well. Eliminating out-of-pocket costs for childbirth is not simply a matter of financial relief; it is an intervention that can prevent a cascade of harm to mothers, babies, and families. The Nevada Legislature should require private health insurers to cover indicated services for pregnant and postpartum women without cost-sharing. Requiring insurers to cover pregnancy-related services with zero cost-sharing, including prenatal care, genetic testing, epidurals, ultrasounds, and medications, would go a long way toward reducing complication rates for mothers and babies alike. Covered services should include, at minimum: ultrasounds, miscarriage care, prenatal genetic testing, delivery services, including anesthesiology, fetal monitoring, and specialist consultations, epidurals and medications, minimal hospital stays, postpartum care for up to one year, including mental health services for mothers, fathers, and adoptive parents. This legislation would ensure that Nevada families can focus on growing and caring for their newborns without the burden of debt or the need to forgo necessary care.