Biological fathers will soon be required to pay half of a woman's pregnancy-related medical costs under a new Utah law that advocates believe to be the first of its kind in the United States.
The law requires the biological father to pay 50% of a pregnant woman's out-of-pocket medical costs, including health insurance premiums and hospital birth. It was signed by Republican Utah Gov. Spencer Cox last month and will take effect on May 5.
Supporters of the legislation say it will lessen the financial burden of pregnancy for women and increase responsibility for men who father children, while critics say it falls short of addressing maternal health care needs and could tie women financially to abusive partners.
Republican state Rep. Brady Brammer, the bill's chief sponsor, said this year that it was part of an effort to increase the "responsibility for men in the bringing of life into the world," according to The Salt Lake Tribune. It was not explicitly intended to lower the frequency of abortions but has prompted debate over abortion access as it could have that effect.
"Oftentimes there's this battle between pro-life and pro-choice, where some of the pro-life positions really turn into a perception that it's just anti-abortion," Brammer told the Utah House Judiciary Committee in January. "I kind of got sick of those things, and I thought, 'What could we do that's really a pro-life thing?' ... And so that's where this bill came from."
Technically speaking, the law amends the terms of the Utah Child Support Act in relation to pregnancy. It stipulates that in cases where paternity is disputed, the costs would be due only after confirmation. The biological father will not be financially responsible if the woman receives an abortion, except in cases where abortion is necessary to prevent the mother's death or if the pregnancy resulted from rape or incest.
Navigating the system
Utah mothers already have the option to seek support related to birth expenses through the court but don't typically do so, Liesa Stockdale, director of the state's Office of Recovery Services, told The Associated Press. She said it remains to be seen how often mothers will choose to seek pregnancy-related payments through the legal system, adding, "Certainly if they do, we're here to collect."
In January, Republican state Rep. Lowry Snow said he worried that the process of going through the courts to collect payment would be daunting but backed the proposal and called it "a really important step in the right direction."
Brammer told The Washington Post's The Lily that the money would be collected in the same manner as child support and in most cases probably not until after the baby is born. He also said the bill does not require a pregnant woman to seek financial support but enables her to make a claim if she chooses.
"The mother still has control of the situation," he said.
While several states have a mechanism for seeking financial support for pregnancy costs from fathers, a Planned Parenthood spokesperson told NPR over email that attorneys believe this to be the first stand-alone bill of its kind, noting that initial research did not yield any existing laws that are "directly comparable."
Costs of pregnancy
Prenatal expenses appear to be increasing. While the Affordable Care Act requires employer-based insurance plans to cover maternity services, a study published last year in the journal Health Affairs found that average out-of-pocket spending for maternity care rose from $3,069 in 2008 to $4,569 in 2015.
Michelle Moniz, an obstetrician-gynecologist at Michigan Medicine's Von Voigtlander Women's Hospital and a researcher with the University of Michigan Institute for Healthcare Policy and Innovation, said at the time that the findings came as a troubling surprise.
"The increasing maternal health costs burdening families over time is concerning," Moniz said. "Research tells us that out-of-pocket costs for health care are often associated with skipped care. These financial burdens put women at risk of delaying or missing maternity care, which we know can lead to poor outcomes for women and babies."
Criticisms of the law
Detractors of the Utah law say it does not do enough to address maternal health care needs.
Karrie Galloway, president and CEO of the Planned Parenthood Association of Utah, said in a statement that "while we appreciate that this bill highlights how expensive it is to be pregnant and that many women struggle to cover the costs of their health care, we feel there are better ways to support pregnant people and families."
Those include expanded Medicaid, better insurance coverage, equitable access to reproductive health care and paid family leave, Galloway said.
"People who become pregnant should be able to determine for themselves what is best for them without legislative interference, compromising their privacy or bureaucratic hurdles," she said.
Others believe that the law will likely benefit only women who have the resources to go through the legal system. Gabriella Archuleta, a public policy analyst with YWCA Utah, which provides services to domestic violence survivors, told the AP that the legislation does not equitably address the high cost of navigating that process.
She is also one of several people to have raised concerns about the implications of the law for women with abusive partners, saying that domestic abuse tends to escalate during pregnancy and seeking such costs could potentially worsen stressors about financially supporting a child.
Democratic state Rep. Brian King, the sole dissenter on the House Judiciary Committee vote in January, said he worried the bill could tie women financially to an abusive partner, noting that it establishes a duty on the biological father to offer financial support.
"I worry that an unscrupulous and abusive male may say, 'Hey, I have this duty. You can't escape me. You may not want to collect it, but I need to be tied to you in a way that you don't want because I have to discharge my duty,' " King said, though he also said he believes there should be more expectation and accountability for men "who are quick to spread their seed and not think they have to be responsible for the consequences."
Democratic state Sen. Luz Escamilla told The Salt Lake Tribune in February that she had gotten clarification from the bill's sponsor and felt confident that the law would "not open doors for anything that could put a survivor of domestic violence in any fear."
Implications for abortion
The law is also prompting discussion of abortion access in the state, which is subject to a slew of restrictions.
Anti-abortion-rights activists believe the legislation will decrease the number of such procedures happening in the state by alleviating economic pressures on pregnant women, as the chairman of the Abortion-Free Utah coalition told the AP.
Jean Hill, director of the Catholic Diocese of Salt Lake City's Office of Life, Justice and Peace, told the Catholic News Agency that the diocese supported the final version of the law and called it a "positive pro-life measure to help women who want to keep their baby but feel overwhelmed by the costs."