JACKSONVILLE, Ill. — Heather Krivillare was a month away from her due date when she was rushed to the operating room for an emergency C-section.
Doctors hospitalized the first-time mother, a high school teacher in rural Illinois, after she developed sometimes life-threatening high blood pressure during her pregnancy. After that, Krivilare’s blood pressure skyrocketed and the baby’s heart rate slowed. “It was scary,” Crivillare said.
She gave birth to a healthy daughter. But then another challenge awaited him. With thousands of dollars in medical debt, Krivilare and her husband struggled for nearly a year to keep collectors at bay.
The Krivillales ended up using nine payment plans while juggling nearly $5,000 in bills.
“There were days when it really felt like a full-time job,” Crivillare said. “I answer the phone after I put the baby to bed. I set up one payment plan, and then I get a new bill that afternoon. Then I have to set up another one.”
Krivilare’s pregnancy may have been more dramatic than others. But for millions of new parents, medical debt is now as much a feature of having a child as long nights and dirty diapers.
About 12% of the 100 million American adults with medical debt owe at least some of it to pregnancy or childbirth, according to a KFF poll.
These people are more likely to report having had to take on extra work, change their living situations, or make other sacrifices.
Overall, the project found that women aged 18 to 35 who have given birth within the past year and a half are twice as likely to have medical debt than women of the same age who have not recently given birth. Another KFF study conducted in
Eileen Atwood, a Rhode Island obstetrician and gynecologist, said, “I feel sorry for my patients because I know they want the best for their pregnancy,” and said she feels sorry for pregnant women who are worried about taking on debt. He said he sees it on a daily basis.
“They very often come to work or to the hospital with school debt due to the financial pressures of starting their working lives,” Atwood said. “They have real choices to make, and those real choices can include choosing not to receive certain services, medications, or things they need to care for themselves or their unborn child.”
best plan
The young couple settled in Jacksonville in part because the rural area, less than two hours north of St. Louis, was a place where two public school teachers could build a home. They made aggressive saves. They bought life insurance.
And before she became pregnant in 2021, Krivilare enrolled in the most robust health insurance plan she could, paying higher premiums to minimize her deductibles and out-of-pocket costs.
Then, two months before her due date, Krivilare learned she had pre-eclampsia. Her pregnancy will no longer be routine. Mr. Krivilare was prescribed blood pressure medication, and doctors at a local hospital advised him to rest at a large medical center in Springfield, about 55 miles away.
“When I was asked to take an ambulance from Jacksonville to Springfield, I remember thinking… ‘I’m never going to get back on my feet financially with this,'” she said. I want you to be safe.”
Krivilare remained alone in the hospital for several weeks as visitors were restricted due to coronavirus precautions. Meanwhile, her doctors steadily increased her medication while monitoring the condition of her fetus. It was “the scariest month of her life,” she said.
After my daughter Rita was born, my fear turned to relief. Because the baby was so small, he had to spend about two weeks in the neonatal intensive care unit. However, she had no complications. “We were incredibly lucky,” Crivillare said.
When she and Rita finally get home, a pile of medical bills awaits them. One was already overdue.
Crivilale quickly worked out payment plans with hospitals, anesthesiologists, surgeons and laboratories in Jacksonville and Springfield. Some providers asked hundreds of dollars per month. Some have made monthly payments of $20 or $25. Some urged Krivilare to apply for a new credit card to pay his bills.
“I felt like I was just constantly on the phone and in a daze while all these different people were collecting money,” she recalled. “That was a nightmare.”
Big costs, big results
Crivilales’ bill was not unusual. Parents with private health insurance currently have to pay an average of more than $3,000 in medical bills related to uninsured pregnancies and births, according to researchers at the University of Michigan.
Families with newborns who require a stay in the neonatal intensive care unit have even higher out-of-pocket costs, averaging $5,000. And for one in 11 of these families, the researchers found that medical costs related to pregnancy and childbirth exceeded her $10,000.
“This forces families to make very difficult tradeoffs,” says Michelle Moniz, a University of Michigan obstetrician-gynecologist who worked on the study. “Even though I have insurance, I am still getting extremely high bills.”
National polls show that millions of these households end up in debt, sometimes with devastating consequences.
Nearly three-quarters of U.S. adults with debt related to pregnancy or childbirth have cut back on spending on food, clothing and other necessities, a KFF poll found. .
About half have postponed buying a home or delaying their own or their children’s education.
These burdens have led to calls for limits on out-of-pocket medical expenses related to pregnancy and childbirth.
In Massachusetts, state Sen. Cindy Friedman has proposed a bill that would exempt all these bills from copays, deductibles, and other costs. This would be similar to federal rules that require health plans to cover recommended preventive services, such as annual physicals, at no cost to patients. “What we want…is healthy children, and that starts with healthy mothers,” Friedman said. Massachusetts health insurers have warned that the proposal would increase costs, but an independent state analysis estimates that the bill would only increase monthly premiums by $1.24.
harsh lesson
Krivillare said she wants new parents to take a breather before paying off medical debt.
“No one is properly prepared to deal with a situation like that when a baby is born,” she said, noting that college graduates can afford this much time off. “When I graduated with my college degree, I said, ‘Emerging adults, it’s going to take you six months to figure out your life. So I’m going to give you a six-month grace period before your student loans. I was like, “If you do that, you can get a job.”
Rita is now 2 years old. With the help of Krivilare’s side business selling resources for teachers online, her family juggled a payment plan and paid off her medical debt within a year.
However, last year Rita had a recurrence of ear infections that required surgery, leaving her family with thousands of dollars in new medical bills and now back in debt.
Krivilare said the stress made her reconsider whether to see a doctor, even for Rita. And she added that she and her husband were determined that their family was complete.
“For us, we can’t have another child,” she said. “I just hope that we can help society by repealing some of these huge bills. [Rita] The life we want to give her. ”
About this project
“Diagnosis: Debt” is a reporting partnership between KFF Health News and NPR that examines the scale, impact and causes of medical debt in America.
This series uses KFF’s proprietary polling, court records, federal data on hospital finances, contracts obtained through public records requests, data on international health care systems, and a year’s worth of financial assistance and collection policies for more than 500 hospitals nationwide. Based on extensive research. .
Additional research was conducted by the Urban Institute, which analyzed credit bureaus and other demographic data on poverty, race, and health conditions for KFF Health News to determine where U.S. medical debt is concentrated; We investigated what factors are associated with high debt levels.
JPMorgan Chase Research Institute analyzed the records of a sample of Chase credit card holders to find out how high medical bills affect customers’ balances. The CED Project, a Denver nonprofit, also partnered with KFF Health News to survey its clients to find out the link between medical debt and housing instability.
KFF Health News journalists worked with KFF pollsters to design and analyze the “KFF Health Care Det Survey.” The survey was conducted online and by phone in English and Spanish among a nationally representative sample of 2,375 U.S. adults from February 25 to March 20, 2022. This includes 1,292 adults with current medical insurance debt and 382 adults with medical insurance debt in the United States. For the past 5 years. The margin of sampling error is plus or minus 3 percentage points for the entire sample and 3 percentage points for those with current debt. Results based on subgroups may have a higher margin of sampling error.
Reporters from KFF Health News and NPR also conducted hundreds of interviews with patients across the country. We spoke with doctors, health care industry leaders, consumer advocacy groups, debt lawyers, and researchers. and reviewed numerous studies and surveys on medical debt.
