The Bulletin Board

State aims to help birthing centers, midwives with rising malpractice insurance premiums

By: - September 12, 2022 12:43 pm

The Concord Birth Center will close next year because owner Kate Hartwell can no longer afford medical malpractice insurance. (Courtesy)

The state’s five birthing centers and home birth midwives may be getting state assistance to help with a significant spike in their malpractice insurance premiums, a jump they say threatens their ability to stay open.

One provider saw its premium jump by $40,000 a year, a 250 percent increase, and the owner of the Concord Birth Center has decided to close next year, citing the climbing cost of insurance. Providers must have malpractice insurance to receive Medicaid reimbursement and coverage by commercial insurers.

Closures are not a risk the state can afford, public health officials have warned. Since 2020, 10 hospitals have closed their delivery units and another is seeking to. If it does, the state would have just 15 hospitals delivering babies.

In a 9-1 vote, the Joint Legislative Fiscal Committee approved a request from the Department of  Health and Human Services Friday to use $252,000 in federal pandemic aid to offset the cost of premium increases. Providers would be eligible for up to 60 percent of their premium increase. 

The money won’t be available immediately. The request still needs the approval of the Executive Council, which is likely to consider it next week. Jake Leon, department spokesman, said if dispersing the money requires a contract, that would also go before the council, likely “in a few months’ time.” 

Patricia Tilley, state director of public health, described the spending to the committee as a “stopgap measure” to help providers “get back on their feet.” The spike in insurance premiums coincided with COVID-19 and an increase in people seeking alternative pregnancy care. 

Birth centers use fewer medical interventions and average half the cost of labor and delivery services at hospitals. Midwives at birth centers also provide childbirth and nutrition education, home visits, additional office visits, and initial newborn screenings.

This is the department’s second effort to support birthing centers. In August, Gov. Chris Sununu signed Senate Bill 408, which increased their Medicaid reimbursement rate for the first time in several years. At Friday’s committee meeting, Sen. Gary Daniels, a Milford Republican and member of the committee, raised concerns about using federal funds to address what could be an ongoing increase in malpractice insurance costs. He also noted that the Legislature had already increased support to the birthing centers with SB 408.

Daniels cast the lone vote opposing the department’s request.

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Annmarie Timmins
Annmarie Timmins

Senior reporter Annmarie Timmins is a New Hampshire native who covered state government, courts, and social justice issues for the Concord Monitor for 25 years. During her time with the Monitor, she won a Nieman Fellowship to study journalism and mental health courts at Harvard for a year. She has taught journalism at the University of New Hampshire and writing at the Nackey S. Loeb School of Communications. Email: [email protected]