Thread: NE-Effects of lost prenatal coverage being felt

The burden has fallen hard on the guardians of health care for pregnant women.

Since the state complied early last year with a federal mandate to exclude prenatal coverage for about 1,600 women, and then chose not to find an alternative way to pay for that care, the effects have mounted for women, their babies and the providers who care for them.

Across the state, according those providers, babies have died because their mothers did not get prenatal care. Women have traveled long distances for care. And babies have been delivered in clinics, ambulances and emergency rooms, and received more expensive intensive care.

Among bills left sitting on legislative committee to-do lists in the 2011 session was one that would provide a method to pay for prenatal care for women ineligible for Medicaid.

The bill's sponsor, Lincoln Sen. Kathy Campbell, didn't push her bill (LB599) during the tough budget session. It would cost about $6.5 million a year in state and federal funds, according to the bill's fiscal note. About $2 million would be state funds.

But she wanted it to have a hearing to remind people of the effects on women, babies and their medical providers of the state's decision in early 2010.

At the time, 1,619 women were deemed ineligible for Medicaid, including 752 citizens and legal immigrants, and 867 undocumented women.

As the months go by, the effects of the lack of prenatal coverage grow.

In April, Lincoln obstetrician Sarah Cada was on call when a woman from a small town miles away came to a Lincoln emergency department in preterm labor -- barely half way through the pregnancy -- and with a significant uterine infection.

Within 45 minutes, the baby was born.

Another 45 minutes, and the infant was dead.

Cada said by the time the mother arrived, and with no prenatal care, there was nothing the medical staff could do. The baby was too small.

Moms who don't have prenatal care are at an increased risk of having low birth weight babies, even at full term, and the babies are at a higher risk for learning and physical disabilities. When that happens, Cada said, it is taxpayers who will pick up the costs of schooling and medical care for those children.

A baby who is born prematurely, with significant complications, can run up a hospital bill of hundreds of thousands of dollars.

"It's so much cheaper to pay for prenatal care than to wait until the baby winds up in the NICU (neonatal intensive care unit)," said Jearlyn Schumacher, a certified midwife. "It's the most short-sighted attitude I've ever seen."

Schumacher, who co-owns Heart and Hands Womancare with Nancy Peterson, also has seen the effects on her business. Schumacher and her partner have both taken sizable pay cuts in order to sustain the practice and pay their staff.

In addition to the higher number of patients who cannot pay, the volume of patients coming to the practice has gone down about 25 percent, Schumacher said.

Half of the women they see are Hispanic and uninsured. And a number of them are at high risk for complications in their pregnancies. Diabetes is more of a threat to this population. And some have previously undiscovered health problems, such as heart conditions and thyroid disorders.

This week, one woman who delivered her baby had not been seen by a doctor since her 28th week of pregnancy. Her blood pressure was much too high and she was concerned about the baby's decreased movement.

"The risk of complications are high during the last trimester," Schumacher said.

Dr. Sean Kenney, a Lincoln physician who specializes in high-risk, or complicated, pregnancies, said the state's decision not to find alternatives to help pay for uninsured pregnant women's prenatal care has escalated the numbers of patients he sees who either cannot pay or who try to pay what they can.

Uninsured patients, including undocumented mothers, can apply for coverage of the labor and delivery as an emergency service, but Kenney said providers have had a hard time getting them to complete that daunting paperwork.

The number of patients he has seen in this year also is down, he said. About 70 percent of the patients he sees are or were on Medicaid, including women addicted to drugs, low-income women and teens.

Providers say patients in Lincoln have more options than those in more rural communities in Nebraska.

Joan Anderson, executive director of the Lancaster County Medical Society, said some funds are available to assist moms who are uninsured, with discounted care, prenatal vitamins and ultrasounds.

Lincoln's Peoples Health Center, one of the state's six federally funded community health centers, provides discounted care on a sliding scale, charging a flat fee of $30 an office visit for prenatal care for patients with no income. Each visit costs the clinic about $100, said Deb Shoemaker, executive director.

About half of the clinic's patients are uninsured. It gets about 17 percent of its funding from the federal government, about 13 percent from state grants and 12 percent from local foundations and funders. The rest is from patient fees.

Campbell, whose bill would require the state Department of Health and Human Services to implement a separate program under the Children's Health Insurance Program for prenatal and pregnancy services for those uninsured moms, said meetings on the issue would resume next month.

The bill would cover unborn children of undocumented women, U.S. citizens with sanctions unless there is a domestic violence issue, and others, including incarcerated women.

Trying to quantify the problem is still an issue, Campbell said.

"I anticipate we will try and address the issue in the next session," she said.

Reach JoAnne Young at 402-473-7228 or jyoung@journalstar.com.

Read more: http://journalstar.com/news/state-and-r ... z1T3n33Z15

Squirt the Anchor babies out back in Mexico. Problem solved..

What this article doesn't tell you is if the pregnant mothers choose to see a Dr or not. It's also possible they didn't know they were pregnant or were in denial that they were pregnant when they had their premature babies.

Most medical establishments will let you make payments and will not turn away someone in need so not getting prenatal care is a personal choice. I'm also sure that there are churches and other organizations that would be willing to help these women.

Exactly Mayday! This is a Liberal argument for giving non-emergency care at tax payer expense. These pregnant women can pay for their prenatal care. No one is denying them prenatal care. They are choosing not to pay for and get treatment. Noting you can do about cheapskates but something can be done about freeloaders.

Don't get pregnant, if you can't even afford the prenatal care.

Dixie