State sued over prenatal services

By Paul Hammel

LINCOLN — Eight months pregnant and with a history of gestational diabetes, an Adams County woman faces birth complications and brain and heart defects in her baby.

She went to court Thursday seeking to reverse the state’s decision to end government-paid, prenatal services for illegal immigrants and some other low-income women.

The 38-year-old woman, identified as “Jane Doe” in court documents, is one of about 1,550 pregnant women who lost prenatal services as of March 1.

In a lawsuit filed on behalf of these women, the Nebraska Appleseed Center claimed the state is required to provide such services for unborn children under its Children’s Health Insurance Program, or CHIP.

The Appleseed Center feared there would be cases like “Doe,” in which poor women, with no prenatal care, would face higher-risk deliveries and greater chances of birth defects for their children, said Becky Gould, the center’s executive director.

For the full story, visit Omaha.com

The 8-page Prenatal Care Issue Brief argues that prenatal care matters for a lifetime by improving life chances for the infant, demonstrates the price that babies pay if they are denied prenatal care, and makes the case that healthy babies is worth the investment of our resources.  As a result, Voices for Children recommends that prenatal care be restored for all soon-to-be Nebraska babies and that coverage should be extended to more low-income women.

The report is available to download from the website or you can request a printed copy by contacting Jill Westfall at Voices for Children in Nebraska (402) 597-3100 or jwestfall @ voicesforchildren.com.

Once you get a chance, let us know what you think about the issue brief in the comments below.

Sign On Letter to Senators 4-1-10

Sign On Letter to the Governor 4-1-10

Although there are no words to express our disappointment in our state’s leaders for failing to put the health of babies over politics, we must express that it is some small consolation to see the outpouring of support for this cause from Nebraskans across the state.  In just 13 days, over 1,300 people signed on to this letter in support of prenatal care for soon-to-be Nebraska babies – that is over 100 signatures PER DAY.  This is an incredible outpouring of support for this issue.  Thank you for using your voice on behalf of babies born healthy in our state.

We have left the sign-on letter open for the time being, so please sign on if you haven’t already and share it with your friends and family.  We will send Governor Heineman and state legislators an updated copy of the letter at the end of the legislative session.

Enter your name below to be added to a sign-on letter to Governor Heineman and members of the Legislature. Then be sure to share this page with your friends and family and encourage them to sign-on too.

“To Governor Dave Heineman and Members of the Legislature:

As Nebraskans, we urge you to take action to protect the health of babies born in our state.  Prenatal care saves babies’ lives, helping them to be born as healthy as possible.  It also saves money by preventing costly poor birth outcomes, the results of which may persist throughout a child’s life.

There is a simple solution to protecting prenatal coverage for expectant mothers.  The State Children’s Health Insurance Program (SCHIP) allows an “unborn child option,” under which services can be provided to pregnant women who are otherwise ineligible for Medicaid.  We, the undersigned individuals and organizations, urge you to take up this option and preserve our long-standing policy of ensuring that babies are born healthy in our state.

As Nebraskans we believe that all babies should have the opportunity to be born healthy.

Sincerely,”

The sign on is now closed.

As with many of the 6,000+ expectant moms who received these letters, they panicked.  They cried.  They frantically called family members, caseworkers, their doctors and nurses, their clinics – many of whom could offer little solace or additional information.  These expectant women just had to wait for a second letter, which would tell them whether or not they could afford to see a doctor for the remainder of their pregnancy.

One of the women received good news in their follow-up letter, and sadly, the other did not.  The woman who received the Medicaid card in the mail with her name on it spoke about the overwhelming sense of relief that she felt knowing she would be able to continue see a doctor and give her baby everything needed to ensure he or she was born healthy.

The other woman, who was four months pregnant, told me of her despair to find out that she lost access to Medicaid on March 1^st.  Her pregnancy is considered high risk, and she had been seeing a doctor twice a week to ensure the baby was growing and developing safely.  So far, so good….. This mom works the night shift at one of the largest employers in the state of Nebraska and does not have health insurance benefits available to her through her employer.  Upon her most recent visit to her doctor, she informed him that she had lost her Medicaid.  Her doctor would now require $238 per visit to continue seeing her.  The woman told me that if she wanted to continue to make her house and car payments, $238 per visit was not an option.  She said she’d be lucky if she could afford to see the doctor once a month.

I was struck by this stark comparison – when both of these pregnancies began, the state of Nebraska cared about the health of both of these unborn children enough to support these mothers when they needed help.  Months later, the state of Nebraska has made a decision about the health of which pregnancy we, as a state, still value and which family we believe should fend for themselves.

Both of these women are U.S. citizens. The impact of this policy change has not been restricted to undocumented women – 709 U.S. citizen expectant moms also lost coverage on March 1^st, along with 842 undocumented pregnant women.  The expectant mom who lost Medicaid was cut off of the program because she made less than $1 over the income eligibility threshold.  Because she made $1 too much, the state of Nebraska deemed that she now makes enough money to afford these visits on her own.

You want to know the real story?  If we fail to fix this, it is the babies that will suffer. The baby will suffer when mom can’t afford to see a doctor for those incredibly important nine months of pregnancy.  The baby will suffer when mom doesn’t know that she can no longer take certain medications or use certain chemicals because they cause birth defects.  The baby will suffer when mom doesn’t know how to manage her diabetes, which affects fetal development.  The baby will suffer when mom has a genetic disorder that can be easily treated with prenatal care, but without, must deliver prematurely.  For those who oppose this policy to appear “tough on immigration,” the real policy stance being taken is “tough on babies.”

The life and health of babies is the worst place to make a political point.  We all know that prenatal care helps babies be born as healthy as possible.  And we all know that babies deserve every opportunity to be born healthy.  This is about keeping babies healthy and saving babies’ lives.  Prenatal care has been and will always be about ensuring that babies are born healthy.  Let’s remember what is truly at stake here.

LB 1110 will restore our prioritization of prenatal care for soon-to-be Nebraska babies.  To take action, please visit Voices for Children’s website: http://www.voicesforchildren.com/babiesbornhealthy.htm

We have created talking points, fact sheets, and provided contact information for senators.  LB 1110 will come up for full debate in front of the Legislature in the next couple of weeks.

The message is simple: “Protect prenatal care.  Support LB 1110.”  Your legislators are listening.  Tell them how you want them to vote.  Help babies in Nebraska have every opportunity to be born healthy.

Written by:

Tiffany Seibert
Policy Coordinator
Voices for Children in Nebraska
7521 Main Street, Suite 103
Omaha, Nebraska  68127
Phone: 402.597.3100 Ext. 109
tseibert@voicesforchildren.com
www.voicesforchildren.com

Photos compliments of http://tammymueckephotography.com/blog/

Nebraska Children’s Home Society has worked with pregnant women for 116 years.  On a daily basis women contact us to ask for help with unplanned pregnancies.  Our caseworkers assure each woman that we value her as a woman and as a mother and that we value her unborn child.  We work with her to help her face the reality of her situation and make a responsible plan for parenting or adoption. We do not refer for abortion.  Over half of the women served develop a parenting plan; less than half place for adoption.

When a woman comes to us for help, one of our top priorities is to connect her to a resource for prenatal care.  That referral is consistent with our message that both she and the baby are very special people and that the mother is responsible for taking care of both herself and the baby so that both are healthy.  Fortunately, most women have had coverage for the costs of prenatal care either through a private insurer or Medicaid.  We do not charge any fees for pregnancy services or adoption.  We can provide these services at no charge because of the generosity of donors who have supported our work for over a century.  If the woman has no health insurance or inadequate health insurance, we pay for prenatal care.  We have not yet determined what we will do if the legislature does not restore coverage for prenatal care for low income women.

Perhaps fewer women will seek our assistance.  Many of our referrals come from physicians.  With no prenatal care available, many pregnant women will not see a physician and the referrals will not occur.  Perhaps more women will make the decision to terminate their pregnancies if they face continuing a pregnancy without medical care.

There are some predictions we can make.  More women will deliver pre-term low birthweight infants.  Some of those infants will not survive; others will survive with life long disabilities.

Our caseworkers already have their work cut out for them as they work to convince women that it is important to obtain prenatal care.  Now we are left to say that their life and their child’s life may depend on prenatal care, but it is not available to them.  I hope that common sense prevails and that the state makes a decision to insure that all babies born in this state have the opportunity to survive and thrive through access to prenatal care.

In the words of Kate Douglas:  Every child born into the world is a new thought of God, an ever fresh and radiant possibility – Kate Douglas

Nebraska Right to Life is on record with testimony in front of the Health & Human Services Committee on February 25th, in support of LB 1110, Prenatal Funding.  LB 1110 recognizes the humanity of all unborn children. Unborn children are the among the most innocent and defenseless members of the human family. To deny them prenatal care when they are in their most vulnerable stages of maturing, could have dire consequences down the road if and when they are born.  Moreover, as instant U.S. citizens at birth, these babies will continue to receive publicly-supported care.  It is not the pro-life position to turn our backs on children in the womb who are innocent with regard to the circumstances of their conception and immigration status of their mothers.  Please put these babies ahead of borders and support LB 1110.

Founded in 1973, Nebraska Right to Life is a statewide, non-partisan, nonsectarian, nonprofit organization established to serve groups and individuals who wish to effectively defend the most basic of all human rights – the right to life. http://www.nerighttolife.org



As more attention continues to be paid by the media and others to the issues surrounding the birth of healthy babies, it’s easy to pull back and look at the dollars and cents, or the various policies that could be applied.  The further we delve into the intellectual debate, the harder it is to remember that there is one basic concept that all people from all sides of all issues can whole-heartedly support:  we’d rather see a baby born healthy than one born with preventable health issues that may affect them for a lifetime.

In fact, the question itself seems silly.  Do you want babies that are born to be as healthy as possible?  No one says no to that question.  Of course we’d all prefer that every baby born anytime, anywhere be healthy and endowed with as good a chance as anyone else to live a happy, successful and fulfilled life.  Duh, right?

Most people would also agree that access to prenatal care is probably the best chance babies have to be born healthy.  It’s common sense that lack of prenatal care poses a higher risk to the health of the mother and of the baby, and that’s before anyone breaks out the stacks of studies to back it up.

No doubt it’s easier to make policy or calculate the spreadsheet if you don’t allow yourself to see each baby as a precious bundle of potential that you can’t help but smile at when you see them in a restaurant, or in a stroller at the mall.  As long as you don’t let yourself dwell on the hardship the lack of prenatal care can create  – emotionally, spiritually and financially — to both the baby and the family, you can debate fiscal responsibility and immigration and the welfare system and all of the other issues that may come into play.

But remember that when it comes right down to it, we all agree:
Babies born in Nebraska are an integral part of Nebraska’s future.
We want all babies to be born healthy.
We realize that the best chance a baby has to be born healthy is when the mom – no matter her age, race, income level or citizenship status – does everything she possibly can during her pregnancy to protect and nurture her baby.
We know that doctors and nurses are experts in how to do help babies be born healthy.  They can spot potential complications and treat mother and baby with the best medical care, helping baby be born as healthy as possible.
We understand that limited or non-existent prenatal care increases the risk that the baby will not be born as healthy as they can be.

Seems pretty simple, don’t you think?

photos compliments of http://tammymueckephotography.com

Voices for Children in Nebraska testified in support of protecting prenatal care at the hearing for Legislative Bill 1110 last week in front of the Health and Human Services Committee.  LB 1110 will restore access to prenatal care for babies of low-income mothers, protecting a long-standing policy of prioritizing the health of  soon-to-be Nebraska babies. See Voices for Children in Nebraska’s Testimony here: http://www.voicesforchildren.com/pdf/Legislative/2010/LB_1110_Testimony.pdf

Voices for Children in Nebraska was joined by an impressive array of child advocates, all supporting access to prenatal care.

Proponents at the LB 1110 hearing included:*

Alegent Health

Bryan LGH Health System

Building Bright Futures and the Nebraska Children’s Healthcare Alliance

Building Bright Futures Early Childhood Services

Creighton University and Creighton University Medical Center

Dr. Richard Raymond, former NMA President and former Chief Medical Officer in Nebraska

Senator Lowen Kruse

March of Dimes – Nebraska Chapter

Mexican American Commission

Nebraska Appleseed Center for Law in the Public Interest

Nebraska Catholic Conference

Nebraska Children’s Home Society

Nebraska Dietetic Association

Nebraska Hospital Association

Nebraska Medical Association (NMA)

Nebraska Right to Life

One World Community Health Center and the Nebraska Federally Qualified Health Centers

Public Health Association of Nebraska

State Auditor Mike Foley

University of Nebraska Medical Center

Voices for Children in Nebraska

*This is not an exhaustive list of all supporters of prenatal care – nor is it the official list of all supporters at the hearing, only those captured in my notes.  Many individuals/organizations may have submitted written testimony or indicated support in other ways.  If I left anyone out, it is unintentional.  Please let me know.

Notable Opponents:

Nebraska Department of Health and Human Services CEO Kerry Winterer and Governor Heineman opposed protecting prenatal care for unborn children in Nebraska, which would overturn a long-standing policy of prioritizing prenatal care for all low-income children that has been in place in Nebraska for at least 20 years.  A letter signed by Mr. Winterer and Governor Dave Heineman indicated their opposition, saying “The key issue to be resolved is whether illegal immigrants should be receiving taxpayer-funded benefits…After a careful and thoughtful review of the various aspects of this issue, we are opposed to illegal immigrants receiving taxpayer-funded benefits.”  You can see the letter here: http://www.voicesforchildren.com/pdf/Legislative/2010/Governor_Heineman_Letter_to_HHS_2.25.10.pdf

Voices for Children in Nebraska respectfully disagrees with Mr. Winterer and Governor Heineman -  the key issue to be resolved is whether soon-to-be Nebraska babies should be given every opportunity to be born healthy. These babies will be American citizens upon birth, and they are part of Nebraska’s future.

If you want to be associated with this great group of prenatal care supporters above, check out Voices for Children in Nebraska’s website that is dedicated to helping you take action to protect prenatal care, www.voicesforchildren.com/babiesbornhealthy.htm.

Tiffany Seibert
Policy Coordinator
Voices for Children in Nebraska
tseibert@voicesforchildren.com
(402) 597-3100