Advocates renew push for prenatal coverage

By JoANNE YOUNG / Lincoln Journal Star | Posted: Saturday, February 4, 2012 8:00 am

Groups wanting to restore prenatal Medicaid coverage to women who no longer qualify are back at work at the Capitol.

They're planning a news conference Tuesday and a candlelight vigil the following weekend to re-energize support for a bill (LB599) that would provide funds to restore care.

The bill, introduced by Lincoln Sen. Kathy Campbell in 2011, has been stuck in the Health and Human Services Committee.

Campbell said the committee has continued to track information on women who are not covered and on their babies and care providers.

It's not a question of if the bill will be addressed by the Legislature, but when, she said.
Healthy children continue to be a priority.

"And prenatal care is so critical to that," Campbell said.

Advocates have never stopped trying to restore prenatal care, said Jennifer Carter of Nebraska Appleseed.
"The urgency for it and the need for it to ensure healthy babies has not gone away," she said.
This has been a busy session in which senators in several committees have focused on healthy kids, she said. And now is a good time to move the bill while there still is time to debate it. The session is scheduled to conclude April 12.

LB599 would require the state Department of Health and Human Services to implement a program under the state Children's Health Insurance Program for unborn children of mothers who lost eligibility for Medicaid coverage in March 2010.

Unborn children had never been included in Medicaid eligibility rules, but Nebraska HHS had, as a practice, included them. When federal workers learned that a couple of years ago, coverage stopped.
At the time, about 1,600 women lost coverage; half of them were in the country illegally.
Women who were citizens lost coverage because they had been sanctioned, for example, for not cooperating with child support requirements.

The bill would restore prenatal coverage July 1. It would cost about $6.4 million a year -- $1.9 million in state general funds and $4.5 million in federal funds. That amount is based on coverage for about 4,700 women thought to be eligible, 3,100 of whom are undocumented.

"We obviously think that's money well spent," Carter said.
It just makes good fiscal sense going forward, considering the challenges for a premature or disabled baby, or one born with low birth weight, she said.

"You have to figure out what your priorities are, and are they kids?" she said. "Then we have to figure out a way to afford what needs to be done."

Jim Cunningham, with the Nebraska Catholic Conference, said it is an important pro-life issue.

"The health and well-being of these unborn children is extremely important," he said. "It shouldn't matter whether the mother is undocumented or not undocumented. Prenatal care primarily helps the unborn child, and the unborn child will be a citizen once born in the United States."

The loss of Medicaid coverage for the women has put the burden on the few health safety net providers in the state.

Rebecca Rayman, executive director of the East Central District Health Department in Columbus, said the Good Neighbor Community Health Center there has gone from serving an average of 139 prenatal patients a year before the Medicaid change to 349 in 2011.

Some women are driving more than 150 miles to get to appointments.

Just about every one of their prenatal patients now pays for their own care, based on a sliding fee scale. The center is discounting care in the amount of $209,400, she said.

They have had to cut behavioral health services and reduce dental services for other patients, and freeze salaries, Rayman said. Staff turnover is high.

In 2010, four babies in the fifth to eighth months of development died in utero, the first deaths of that kind for the health center. Since then, the staff has completely reorganized how it provides care, and no babies have died prenatally, she said.

But it's been difficult.
Only about half begin care in the first trimester.
"This is just not good," she said.

Getting coverage restored will continue to be an uphill battle, she said.

"But there are many difficult things that we have been able to accomplish, in this country, in this state," Rayman said. "The potential is there."

Advocates renew push for prenatal coverage