Rock County case has statewide implications on maternity coverage

By TED SULLIVAN   Wednesday, March 3, 2010
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— A Rock County Court case is raising a question that could have statewide implications: Should insurance carriers be required to provide maternity coverage to surrogate mothers?

Wisconsin Supreme Court justices heard arguments in the case Tuesday, and their decision could reach beyond surrogate pregnancies.

The court’s ruling could impact pregnant women who want to give up their babies for adoption, women who use in vitro fertilization or other types of pregnancies.

It also could decide whether insurance companies have a right to question women about their pregnancies and whether women intend to keep the babies.

The case is the first of its kind, attorneys said, and it could set a precedent in state statute and insurance policy.

The case began when MercyCare Insurance Co. and MercyCare HMO denied maternity coverage to two surrogate mothers insured under their policy. The women made agreements to be gestational carriers for other parents.

One woman filed a complaint with the Wisconsin Office of the Commissioner of Insurance.

The office decided MercyCare could not deny benefits to surrogate mothers. It ruled MercyCare’s policy and definition of “surrogate mother” were unfair and discriminatory.

MercyCare appealed the decision to Rock County Court, and Judge James Welker reversed. The insurance office then appealed, sending the case to the 4th District Court of Appeals and later the Supreme Court.

Supreme Court justices must decide if state statutes allow an insurance company to exclude maternity coverage for surrogate mothers.

Bruce Olsen, assistant attorney general, said pregnancy is a medical condition that requires care to protect mothers and unborn children.

It shouldn’t matter if the pregnant woman has a genetic link to the baby, he said.

A reasonable woman would have thought her surrogate pregnancy was covered under MercyCare’s policy, Olsen said.

Matt Duchemin, a Madison attorney for MercyCare, said the insurance office’s decision to approve coverage conflicts with state statutes.

The statute is broad, he said, and the Supreme Court should interpret its meaning.

MercyCare’s policy complies with state statutes, Olsen said.

Justices asked attorneys several questions during the hearing, saying the language in the insurance policy is vague. They said the language could be viewed differently from both sides.

Justices asked about several pregnancy scenarios to see if women would be covered. They also questioned attorneys about their views of the law.

The Supreme Court did not decide the case. A decision is expected at a future date.

reader COMMENTS
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(30)
shirleyzager
Jun 10, 2010 at 10:03 p.m.
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Insurance companies are notorious for trying
to get out of claims. They should not have a right to deny pregnant subscribers pregnancy and delivery benefits based on how they got pregnant or where the baby is going. This
is clearly discrimination of women and raises privacy issues. I support the efforts of the Wisconsin Commissioner of Insurance to ensure all pregnant women will
be treated equally. I am hopeful the state Supreme Court will support the Commissioner.

totellthetruth
Mar 8, 2010 at 6:57 a.m.
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My question is what kind of idiot gets paid to carry a baby and then asks for their insurance company to pay what they have been paid for??? I have to agree with the insurance company here. Asking for payment boarders on fraud.

Mikki
Mar 5, 2010 at 10:45 a.m.
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timewas-exactly.
I work closely with different social service agencies...you'd be surprised how many women are on full public assistance yet are still reproducing.
They can't afford to feed and care for the children they already have, but still want more.

mommy2three
Mar 5, 2010 at 10:44 a.m.
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I agree with others that in my opinion the surrogates insurance shouldn't have to cover the pregnancy, the baby's parents insurance should. After all it is their, dependant she is carrying... They should be responsible for all costs. The mom is already doing them a huge favor by carrying the baby, it's the least they could do.

miltonman
Mar 4, 2010 at 8:39 p.m.
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Just because some people get Badger Care, Low rent assistance, Wic Checks and a free cell phone every month you shouldn't get to mad. Just go to work and forget all this BS. Ya know getting PG and havin babies ain't easy don't cha know. These people are populating society, You betcha this ain't the easy life you think it is. Gotta wear the same clothes year in and year out.

brightjade
Mar 4, 2010 at 4:46 p.m.
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let's see why can't everyone in the state of wi be on badger care...that would be just great figure out what a family and single person would need to pay and let us all use it...MY medicare and supplement will not cover all my medication. I know there are a l lot more than just me around ..maybe a s mall co payment at dr and so on , , would be great if we were the first state to do this.....I am not educated enough to figure this out maybe some of you are,then this story would not even have to be told would it.....

JohnWicket
Mar 4, 2010 at 4:22 p.m.
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I really like the breeder colony idea for purposes of taxation. This harkens back to the days of the founding fathers. We might also look at harvesting organs for profit or hasn't that already been done? What a brave new world we are to become.

Sandman
Mar 4, 2010 at 1:17 p.m.
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"A reasonable woman would have thought her surrogate pregnancy was covered under MercyCare’s policy, Olsen said."

"Reasonable woman"? Good luck finding one of those! But seriously, assuming the possibility for one does indeed exist, a "reasonable woman" would have asked her insurance company first before she went and committed herself (hey--now now there's an idea!) to carrying someone else's baby (for profit, or just for good measure?). I don't want my insurance--or taxpayer dollars--going to support this nonsense. You want one by someone else, you pay for it!

Hey wait--but there's an idea for a little local cottage industry in Rock County! Maybe we could develop a breeder colony of surrogate mothers and tax it heavily (just like Ethiopia and all the other like countries are doing). The local "talent" has proven itself time and again to be ripe, willing and ready, and such a program could...fill our coffers (if that's what you young folks are calling it nowadays)! Maybe that's how we can pay for the Milwaukee street underpass (somehow fitting, wouldn't you agree?) AND the ice arena to boot(y).

Mikki
Mar 4, 2010 at 1:16 p.m.
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Why should insurance cover this?
So someone wants to be compensated for the "job" they do and get free health care. As for friends and family...if they choose to do this, the recipient of the "gift" should pay.
Why do insurance companies have to foot the bill for this?
If insurance companies have to do so, soon after Badgercare will be expected to do so, as well.

momof5
Mar 4, 2010 at 11:59 a.m.
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Yeah. The only "magnet hospital" in this area...definitely a discount hospital. One of only 2 nicu's within 60 miles. Lol! Discount hospital! Like I said a VAG delivery. Haven't had a section in 10+ years. Which, if you read my comment, is what I asked phred: if she had a section. We spent 2 days in special care and our bill was nowhere near 20k, but I did NOT have a section.

JD5
Mar 4, 2010 at 11:49 a.m.
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Momof5..Not sure if you were at a discount hospital or what, but a c-section & 2 days in the hospital was over $30K within the last year!

mommy2three
Mar 4, 2010 at 11:24 a.m.
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littlemom:
Just FYI I have the state insurance, and YES I work to support my family the best I can. If you haven't noticed there aren't a lot of jobs right now that will pay more than minimum wage. Not everyone who needs state help is just sitting on their butt eating bon bons all day. Yes some abuse the help but don't take it out on those of us that are doing our best to make ends meet but still can't get by... Everyone needs a little help sometimes, so jump off your high horse because god forbid someday you might need the help!

Ouisch
Mar 4, 2010 at 10:35 a.m.
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I think the woman who chooses to be a surrogate mom should have her own insurance cover her pregnancy. Only because it's her body that needs to be covered regardless of any profit or what happens afterward.
The new parents will need their own insurance for their addition once it's born.
Odd question, can't someone insure their body parts regardless of what they use them for (ballplayer, model, performer)?

momof5
Mar 4, 2010 at 9:27 a.m.
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Phred: there must have been some sort of complications and/or a c-section in there for 20k. One of my kids was a preemie. Even so, a "normal delivery" and 2 nights in "special care" were still well under 10k.

momof5
Mar 4, 2010 at 8:27 a.m.
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I don't think the insurance of the gestational carrier should be forced to cover the surrogate prenancy. I do, however, think the insurance company of the biological parents should be made to cover this pregnancy. It is their child: the surrogate is "just" the oven.
.
And, YES, surrogates are compensated. Sometimes very very well: generally between 20 and 50 THOUSAND!!

phred
Mar 4, 2010 at 8:25 a.m.
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To those questioning whether or not the moms get paid for surrogacy... Not all moms do. Some women do it for friends or family members who cannot have their own children. Being a surrogate does not necessarily mean that you are having a baby to make money. I just had a baby. (My own.) The hospital bills for the delivery and stay (not including the doctors performing the delivery) were well over $20K.

werpknarly
Mar 4, 2010 at 7:52 a.m.
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its it littlemom or littlemind? Read the paper much? unemployment are 15% in rock county?.. AND the Money to support pregnant mothers is really for the children, not the mother. or do we just throw them down the hole like the philistines did?

proartist
Mar 4, 2010 at 7:26 a.m.
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Would this question ever be an issue in the public realm if the roles were reversed?...."It also could decide whether insurance companies have a right to question MEN about their USE OF VIAGRA WHICH IS COVERED BY MEDICAL INSURANCE and whether the MEN intend to keep the babies.....The Supreme Court justices must decide if state statutes allow an insurance company to exclude 'male enhancement' coverage for fathers."

loopylibertarian
Mar 4, 2010 at 7:07 a.m.
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jv92, I'm with you on the questions. I thought those women get paid and also get help with the medical costs by the people who hired them for surrogacy. If it is a business transaction/contract between the surrogate and the family, then a 3rd party shouldn't have to be forced into financial obligations like that. Surrogacy and becoming pregnant then giving up a baby for adoption are 2 different things, so I don't see how one would impact the other. This is too complicated.

SarahB1
Mar 4, 2010 at 2:27 a.m.
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littlemom: What are you ranting about? I would bet that the majority of women on medical assistance do have jobs.

jv92
Mar 3, 2010 at 10:48 p.m.
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Honest question...do women who agree to be surrogates receive compensation for doing so?

biggirl
Mar 3, 2010 at 9:10 p.m.
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Hey, personally, littlemom, I don't want my tax dollars to go for any number of wars -- the wars in Iraq, Afghanistan, and the war against drugs.

littlemom
Mar 3, 2010 at 8:29 p.m.
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This case should not be just for MercyCare Insurance coverage of pregnancy or not. This goes further than that. This should be further investigated by Medical Assistance and BadgerCare programs. Personally I do NOT like the idea when my tax $$$$'s are covering women who do not want to go and find jobs and take care of their own families, PERIOD!!!!!!

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