May 14, 2019

Not all bad

There were some rough and embarrassing moments in the last legislative session, but some good things came out of it.

One that surprised me was the passage of Senate Bill 564, which raised the Medicaid eligibility threshold for pregnant women to 300 percent above the federal poverty level. The bill also provides coverage for the mother for 60 days after birth.

That’s a big deal for several reasons. Obviously, it can improve the health of both the mother and child. More importantly, it can significantly reduce the chances of infant and maternal mortality. Unfortunately, the maternal mortality rate in the U.S. has been increasing.

According to Dr. Jessie Ice of the West Virginia Center on Budget and Policy, the U.S. has the highest MMR level among advanced industrialized nations. It’s one of only eight countries where the MMR is actually increasing — and it’s the only industrialized nation in that group. Globally, MMRs have declined by 44 percent between 1990 and 2015.

Incredibly, American women today are twice as likely to die from pregnancy-related causes than their mothers were. According to Ice, “The average age a woman gives birth in the United States for the first time is a little over 26 years old. A 26-year-old giving birth in 2014 would face an MMR of 18 out of 100,000, while her mother — 26 years prior — was faced with an MMR of 9.4 out of 100,000.”

American women are three times more likely to die from pregnancy- related issues than Canadian women and six times more likely to die than Scandinavian women.

According to Amnesty International, American women living in low income areas are twice as likely to die than those from more affluent communities. African-American women are three to four times more likely to die than white women.

Something is wrong with this picture, but access to health care during and after pregnancy can help reverse the trend. According to an analysis by several MMR review committees, 63 percent of deaths could have been prevented with access to health care.

It’s hard to estimate how many West Virginia women will benefit from this legislation, but 535 mothers gave birth without health insurance last year.

West Virginia has made some major progress in health care over the last few years. Thanks to Medicaid and CHIP, the state is a national leader in insuring kids. Then-Gov. Tomblin’s decision to expand Medicaid under the Affordable Care Act is now bringing coverage — including treatment for addiction — to 160,000 state residents. Covering more pregnant women is another step in the right direction.

In the future, the Legislature should consider extending postpartum Medicaid coverage to at least one year since not all pregnancy-related physical or mental health issues emerge in the first 60 days. Throw in universal access to voluntary in-home family education or home visiting programs for the first two years after birth and we could go far in preventing all kinds of problems and improving outcomes for kids and families for generations to come.

West Virginia is losing population, especially young parents and children. We could all benefit from taking better care of the kids we have and making the state a great place to live and raise a family.

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