“Mom and baby are home and doing fine.”
When a couple welcomes a new baby into the world, family and friends expect those reassuring words. Yet when babies are born too early, too little or too sick, such comfort is out of reach. Instead, families must watch as their babies fight for their lives in the alternate reality of the neonatal intensive care unit.
There are no politics in the NICU.
In the NICU, parents of the tiniest and sickest patients can’t even touch, let alone hold, their newborns. And families are constantly fearing the worst when a new medical complication arises. Babies of all backgrounds land there, although African-American babies, Hispanic babies and babies from low-income families are the most likely to.
Every mother needs healthcare throughout her pregnancy to help avoid preterm birth and birth complications, with the goal of every baby being born healthy. Yet at a time when the health of mothers and babies in the U.S. is trending in the wrong direction, Congress is laying the groundwork for a dramatic reduction in maternity benefits. Doing so would almost certainly lead to serious long-term human and fiscal costs. Though our most vulnerable populations would pay the highest price, families with private insurance who rely on Medicaid for supplemental support would be hit, too. And as a society, we would all pay for this unconscionable act of neglect.
The Senate’s healthcare bill, unless improved, would rescind Medicaid coverage for up to 6.5 million women of childbearing age, according to an analysis by the organization I lead, the March of Dimes. This will make it harder for women to get healthy before they get pregnant. The bill would also remove maternity care from the list of essential health benefits all insurers on the individual market must provide. States would get to make the call as to whether maternity and newborn care had to be covered. If this coverage becomes optional, studies show that fewer pregnant women would receive prenatal care, and fewer premature babies would receive the specialized treatment they need to survive and thrive.
In America today, a baby has about a one in 10 chance of being born too soon. The average medical cost for a healthy baby is $4,389. For a premature baby, the price tag skyrockets to $54,194. And worrying trends mean more families are confronting these challenges. At 9.84 percent in 2016, the U.S. preterm birth rate has risen two years in a row after a seven-year fall; the percentage of low birth weight babies is rising too. Our infant mortality rate, though relatively low by global standards, is higher than that of many of our peer nations. The U.S. maternal mortality ratio also rose between 2005 and 2013, going against a global downturn in maternal deaths. It is unclear why measures of baby health are worsening, but disparities in access to prenatal care are likely at least partly to blame.
The simple truth is that many women don’t expect to need prenatal and maternity care because nearly half — 45 percent — of all U.S. pregnancies are unplanned. Medicaid expansion has meant more low-income mothers are covered before they get pregnant and has given states the ability to expand care based on their population’s needs. This expansion undeniably helps babies by increasing access to care. With the wide disparity in preterm births and neonatal and maternal mortality across the nation, the need for such coverage is expanding, not contracting.
Meanwhile, cutting benefits would save little while saddling women and new mothers with exorbitant insurance costs. New data from the March of Dimes and Avalere, a healthcare consulting firm, confirm that removing maternity coverage from plans would save a maximum of $10 per month in premiums. Women who want maternity coverage, however, would pay premiums 25 percent to 70 percent higher and could be subject to unlimited out-of-pocket expenses. For women who have no maternity coverage, the out-of-pocket cost could be $15,000 or more.
Of course, the factors that impact mother and baby health go well beyond insurance, which is no panacea. Ensuring healthy pregnancies means giving women in impoverished rural and urban areas access to healthcare facilities, nutritious food and smoking cessation programs. It means making sure young people know how best to avoid unintended pregnancies in the first place. Yet the Senate bill makes no investment in promoting maternal and child health or in seeing to it that moms and infants can get the quality care they need for healthy pregnancies and a strong start in life. And if families lose their health insurance, they might not be able to pay for vital care that could save their baby’s life — in the NICU and beyond.
Let’s not inject politics into the lives of babies at this critical time when all they need is care.
Stacey D. Stewart is president of the March of Dimes, the nation’s leading nonprofit organization for pregnancy and baby health.
The views expressed by this author are their own and are not the views of The Hill.