The biggest overhaul of maternity billing in decades could affect insurance costs, postpartum care, and how pregnant patients navigate healthcare starting in 2027.
A major change is coming to pregnancy care in the United States, and it could affect how millions of families pay for maternity services.
Beginning January 1, 2027, the American Medical Association (AMA) will replace the decades-old “global” maternity billing system with a new structure that allows healthcare providers to bill separately for different stages of pregnancy care. The change will affect prenatal visits, labor management, delivery services, and postpartum care.
For families in California, especially Latino families who account for a growing share of U.S. births, the change could influence insurance costs, medical billing, access to postpartum care, and how pregnancy-related services are covered.
Why the Maternity Billing System Is Changing
For years, most obstetricians used a single bundled payment that covered routine prenatal care, delivery, and postpartum services.
The AMA and the American College of Obstetricians and Gynecologists (ACOG) argue that modern maternity care no longer fits neatly into that model. Pregnancy care today often includes telehealth appointments, remote monitoring, care coordination, specialist consultations, and individualized care plans. The old system did not adequately account for many of those services.
Starting in 2027, providers will report care in four separate categories:
The Four New Billing Categories
- Antepartum care (pregnancy visits and prenatal management)
- Labor management
- Delivery
- Postpartum care
Instead of one bundled payment, providers will be able to document and bill services separately throughout a patient’s pregnancy journey.
What This Could Mean for Families With Private Insurance
For Californians covered through an employer-sponsored health plan or a private insurance marketplace plan, the changes may be more noticeable.
Routine prenatal visits that qualify as preventive care should continue to receive Affordable Care Act protections. However, additional services billed separately may trigger copays, coinsurance, or deductible expenses depending on the specifics of a health plan.
That means families could see:
Earlier Deductible Spending
Instead of one large maternity claim after delivery, insurance plans may receive multiple claims throughout pregnancy.
As a result, families could begin paying toward deductibles much earlier than they do today.
More Complex Medical Bills
Itemized billing often creates more insurance paperwork and explanations of benefits. Patients may need to pay closer attention to what services are considered preventive care versus specialized care.
Potential Long-Term Premium Pressure
Health economists and insurers will be watching closely to see whether more detailed billing increases overall spending on maternity care. If insurers pay more per pregnancy, some experts expect upward pressure on future premiums.
The actual impact will vary significantly depending on each health plan’s deductible, copay structure, and coinsurance requirements.
Why Medicaid Patients May See Different Results
The picture looks different for patients covered by Medicaid.
Medicaid finances roughly four out of every ten births in the United States, making it one of the largest maternity care payers in the country.
For most Medicaid recipients, maternity care already involves little or no out-of-pocket spending. That means the billing changes are unlikely to create new direct costs for pregnant patients.
Instead, supporters believe the changes could improve access to postpartum services.
Because providers will be able to bill separately for postpartum visits and care management, the new structure may encourage more follow-up care after birth, including services that have historically been underutilized.
Could Pregnant Patients Receive Better Care?
The organizations behind the changes say that is one of the primary goals.
ACOG notes that modern pregnancy care increasingly relies on personalized approaches rather than a standard schedule of office visits. The revised coding system is designed to better support:
- Telehealth prenatal appointments
- Remote blood pressure monitoring
- High-risk pregnancy management
- Care coordination
- Extended postpartum follow-up
- Maternal mental health screenings
Advocates argue that the changes could help providers deliver care that reflects how pregnancy medicine actually works in 2026 and beyond.
Why Latino Families Could Feel the Biggest Impact
This story carries particular significance for Latino communities.
According to data from the Centers for Disease Control and Prevention, births among Hispanic mothers increased while many other demographic groups saw declines or slower growth. Hispanic families now account for more than one-quarter of births nationwide and represent an increasingly important share of America’s future population growth.
That means any nationwide change to maternity care affects Latino families at a larger scale.
The effects, however, are likely to be uneven.
Latino Families With Private Insurance
Research has found that Hispanic families are more likely to be enrolled in plans with significant coinsurance obligations.
If more pregnancy services become individually billed, families responsible for a percentage of each charge could experience higher out-of-pocket expenses than they do under a bundled system.
Latino Families Covered by Medicaid
For families receiving Medicaid benefits, the changes may bring expanded access to postpartum services without major new financial burdens.
Uninsured Pregnant Patients
One ongoing challenge remains insurance gaps.
Health researchers have repeatedly found that Hispanic women experience some of the highest rates of uninsurance before, during, and after pregnancy. For uninsured patients, an itemized billing system could make already complicated hospital bills even more difficult to navigate.
Why This Matters in California and Los Angeles
California has one of the nation’s largest Latino populations and one of the highest annual birth totals.
Los Angeles County alone sees tens of thousands of births every year, making maternity care a major part of the region’s healthcare system.
The state’s ongoing efforts to improve maternal health outcomes, expand postpartum coverage, and address racial disparities in pregnancy-related complications mean California providers will be closely watching how the new billing structure affects access, costs, and care quality.
Hospitals, insurers, physician groups, and public health agencies will spend much of 2026 preparing for the transition before the new coding rules officially take effect in January 2027.
In Summary
- The AMA is eliminating traditional bundled maternity billing beginning January 1, 2027.
- Pregnancy care will be billed across four separate phases instead of one global payment.
- Families with private insurance may notice changes in deductibles, copays, and billing complexity.
- Medicaid patients are unlikely to face significant new out-of-pocket costs.
- The new system may improve access to telehealth, postpartum care, and maternal mental health services.
- Latino families could experience a disproportionate impact because they represent a growing share of U.S. births.
The Centers for Medicare & Medicaid Services will continue reviewing payment recommendations and implementation details throughout 2026 before the new codes take effect in 2027. Healthcare providers, insurers, and hospitals are expected to spend the next several months updating billing systems and preparing patients for the transition.
For California families planning a pregnancy in 2027 or beyond, understanding how their health plan handles deductibles, coinsurance, prenatal visits, and postpartum care may become more important than ever.
