Common Sense and Prenatal Care

For years Nebraska has had a common sense, compassionate, and fiscally sound policy of providing prenatal care to low-income mothers regardless of immigration status. But now, over 1,000 pregnant women face the terrifying prospect of losing their coverage for prenatal care as of March 1st. One of the worst parts of this? The coverage could easily be continued at a savings to the state. But the ugly politics of our time seems to be driving bad policy.

The obvious reasons for providing prenatal care are clear to most. First, there is the humanitarian reason of prioritizing the health and well-being of the mothers and babies in this state. Second, the cost benefits of proper prenatal care are clear and well-documented. This is a perfect example of a time when an ounce of prevention saves a pound of cure. The mothers who are about to lose access to prenatal care will be eligible for emergency Medicaid to cover the delivery and the children will be eligible for Kids Connection at birth. It makes much more sense for the state to pay a small cost for prenatal care rather than paying a huge cost in caring for a child born early or with serious complications that might have been prevented.

These women are at risk of losing their prenatal care essentially because the federal agency that oversees Medicaid – the Centers for Medicare and Medicaid Services (CMS) – realized that Nebraska was providing prenatal care, to the unborn child under Medicaid, which is not allowed. To solve the problem, Nebraska simply needs to move these families to the Children’s Health Insurance Program (CHIP), where providing this coverage is allowed, AND the state will receive more federal dollars to do it. This change would simply require the Nebraska Department of Health and Human Services to check a box – literally – on a state plan provided to CMS, and then move these expectant mothers into a different program.

But the state has refused. Instead, we have gone down a path of confusion, misinformation, and fear for expectant mothers who have received multiple confusing notices about the potential loss of their prenatal care. And it has forced the issue into the hands of the Legislature.

This process needs to stop. Nebraska DHHS was only required to provide CMS with a corrective plan within 60 days, not terminate these mothers. The corrective plan should have been to move these mothers into CHIP and receive an enhanced federal match to do it.

There is no magic to the March 1st termination deadline. The state is not being required by CMS to terminate these families by that deadline and if the Governor truly wants to provide the Legislature with time to craft a solution, DHHS needs to move the termination date back to April 1st, at a minimum.

It’s time for Nebraska to remember who we are, what our priorities are, and why a common sense policy like providing prenatal care should not be a political issue.

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