Published Sunday March 14, 2010

Prenatal care debate: Beyond costs
By Paul Hammel

LINCOLN — The 30-year-old woman who walked into south Omaha's OneWorld Community Health Center was scared.

She was 16 weeks pregnant and needed a $50 test to determine if she suffered from a dangerous but treatable prenatal condition.

But she didn't have the money and didn't know where to get it.

OneWorld gave her the test anyway, and she was found to have gestational diabetes.

AdvertisingHowever, the health center for low-income people cannot afford to pick up the $300 cost of what it recommends for such women: a course at the University of Nebraska Medical Center that teaches how to use a glucose monitor and how to manage the diabetes through low-sugar diets, exercise and, sometimes, medication.

The OneWorld patient was among 1,550 women, as of March 1, who lost their state Medicaid coverage for prenatal care because of a directive from the federal government. More than half — 842 — were illegal immigrants.

Medicaid formerly paid about $775 for prenatal care per woman.

Whether the woman with gestational diabetes is an illegal immigrant is unknown. OneWorld, whose clients are mostly Hispanic, doesn't ask about immigration status. Dr. Kristine McVea, chief medical officer of the center, described the woman's health situation without naming her.

McVea, along with the state's medical groups and organizations that oppose abortion, falls on one side of the debate on whether to restore prenatal services to these women. McVea says the compassionate and cost-effective thing to do is to restore such care to women, even those here illegally.

“That someone would think so strongly about immigration that it would supersede the health of a baby …â€