Childbirth in Ohio comes with staggering out-of-pocket costs

After Carrie Arnold gave birth last fall to her first child, Luca, she received two bills of more than $100,000 each.

The 26-year-old Dayton resident said she was billed $127,308 for her hospital costs and $121,390 for her newborn son's stay in the neonatal intensive care unit.

"I had no idea that it was going to be this much; nobody ever tells you," she said.

Check out our latest pictures from in and around Stark County: Did we get a picture of your or someone you know?Arnold's due date was Dec. 12, but her water broke almost 11 weeks early, on Sept. 29.

As a result, she spent a month on bed rest in Kettering Medical Center in Dayton before having a cesarean section on Oct. 25. Her premature son stayed in the neonatal intensive care unit for 17 days.

Fortunately, she had good health insurance through her husband's job, so their out-of-pocket costs ended up being $3,000 -- $1,500 for her medical services, and $1,500 for her son's.

"Three thousand dollars is a lot of money," Arnold said. "Thankfully, we knew ahead of time, and we were able to save up, but it's just there's other things you'd rather spend your money on."

The sticker shock and staggering costs of childbirth can really hurt a family's wallet, many doctors and other experts say.

"It comes at a time when families are facing considerable challenges and readjustment, so a large medical bill can be a huge stressor on top of that," said Carol Sakala, the director of Childbirth Connection Programs at the National Partnership for Women & Families, a Washington, D.C.-based, nonprofit group that works on public policies, education and outreach focused on women and families.

The average out-of-pocket costs of childbirth and maternal care among women with employer health insurance increased from $3,069 to $4,569 -- 49% -- between 2008 and 2015, the latest date for which statistics were available, according to a study published last week in the journal Health Affairs. The rising costs are largely attributed to the rise of high-deductible health plans,

"The magnitude of those costs were really striking," said Dr. Michelle Moniz, the lead author of the study and an assistant professor in the Department of Obstetrics and Gynecology at the University of Michigan.

When it came to vaginal delivery, average out-of-pocket costs increased from $2,910 in 2008 to $4,314 in 2015, according to the study. Out-of-pocket costs for C-section births increased from $3,364 in 2008 to $5,161 in 2015.

"Most of my patients don't have that kind of disposable income," Moniz said.

In Stark County, Aultman Hospital charges $3,870 for a routine vaginal birth. Mercy Medical Center's costs weren't readily available. Cost are customarily available on the the hospitals' "chargemasters" -- lists of billable items and prices for all services provided to patients.

Since Jan. 1, 2019, hospitals across the country have been publishing price lists online to comply with a new Trump administration rule. The figures are not amounts that a patient pays for services but the amount billed by the hospital system to the individual's insurance company, Medicare or Medicaid.

Arnold said, "We are so fortunate that we have health insurance that will cover it, but so many people don't, and you shouldn't have to go into massive amounts of debt to have a child."

OhioHealth said that only about half of its patients with insurance paid any out-of-pocket costs for childbirth; the others either had insurance that covered the full cost, or they received financial assistance, the health system's finance team said.

Patients who made out-of-pocket payments averaged about $1,180 for vaginal births and $1,140 for C-sections in the period from July 1, 2018, to June 30, 2019, the OhioHealth finance team said. It's unclear why the cost of C-sections was less than vaginal births, but it could be because of differences in individual insurance plans, the finance team said.

In some instances, OhioHealth was never able to collect payment from the patient, so it was written off as bad debt, the finance team said.

Evanthia Brillhart, 30, of Westerville, delivered son Beau at OhioHealth Riverside Methodist Hospital by C-section on April 23, 2019, and the hospital bills totaled just over $10,000.

She had a high-risk pregnancy due to a placenta issue and had three sonograms that cost $1,600 each; insurance covered about half of that cost.

Between her prenatal care, labor and delivery, the Brillharts easily hit their $3,000 deductible for the year and their out-of-pocket maximum of $6,000. So the out-of-pocket cost for the delivery was just $600.

"We always planned on having a family," she said. "Just navigating those costs, we do what we have to do to make it work."

Some women find ways to trim the cost of their babies' delivery.

Having a home birth was less expensive than going to Miami Valley Hospital for Marina Genetin, 26, of Dayton.

Genetin said she paid $3,000 out-of-pocket to deliver daughter Zia in her bathtub with the help of two midwives on Dec. 11, 2019. By comparison, she said, it would have cost her $4,000 after insurance to deliver her daughter at the hospital.

"What the hospital would have billed my insurance for is insane," she said.

Although the cheaper cost wasn't the deciding factor in having a home birth, Genetin said, it was a bonus.

Meanwhile, Halle Markwas, 31, of Dublin, qualified for financial assistance to help cover the cost of son Lane's routine birth at Riverside on Feb. 26, 2018.

People with incomes that are at or below 200%, 300% and 400% of the federal poverty guidelines can qualify for discounts at OhioHealth. Last year, that would have been an income of $33,820, $50,730 and $67,640 for a two-person household, respectively.

OhioHealth covered 80% of Markwas' hospital bill, and she and her husband were responsible for paying about $3,600 out of pocket.

"I would never have known what to do, and I would be stuck with a $10,000 out-of-pocket deductible," she said. "I was extremely fortunate."

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