Lincoln Journal Star - April 1, 2010
By Nancy Hicks
Senators plan to set aside $100,000 in state funds to provide prenatal care for a very small group of pregnant women who refuse to provide the names of the fathers of their unborn children because of domestic violence.
The latest plan, which gained official legislative approval Thursday, is far less than a plan that would have covered all of the more than 1,600 women who lost Medicaid prenatal coverage on March 1, and less than a later plan to provide prenatal care for fewer than 700 legal U.S. citizens who also lost Medicaid benefits.
While some senators praised this safety net, others said it was a very small program in light of Nebraska's two-decade tradition of providing prenatal care to all low-income pregnant women.
While some senators have said it's the least they could do, Lincoln Sen. Bill Avery said he would characterize it as less than the least.
"It's clearly not nearly enough," said Avery. "But it is better than nothing."
And politics is the art of the possible, he pointed out.
After the Department of Health and Human Services changed Nebraska's Medicaid rules, eliminating coverage for about one-fourth of the low-income pregnant women, senators discovered the state could cover all low-income women using different federal funds.
However, Gov. Dave Heineman publicly opposed any plan to provide tax-supported care for women who are in the U.S. illegally, including a plan that would have used private donations for the state's share of the care. Senators could not find 30 votes to override a veto for either plan.
A later proposal to provide care for only U.S. citizens failed when senators weren't able to get adequate information on how many people might be in that group quickly enough to pass legislation this session.
Heineman does support the latest plan, according to an e-mail from his staff.
The original goal to continue to provide care for all unborn babies fell to the politics of immigration, said Lincoln Sen. Amanda McGill.
"I refuse to stand here and let us all pat ourselves on the backs," she said. "There are a lot of Nebraskans whose dislike for illegal immigration is more important than their pro-life mentality.
"This hatred and dislike for illegal immigrants ... is what has driven the politics of this issue," she said. "We had an opportunity to truly be pro-life, and we passed it over because of the politics of immigration."
McGill also pointed out that babies of illegal immigrants, once born, are U.S. citizens and will qualify for Medicaid-funded health care.
"These children are our children. They are American citizens. They are going to be covered once they are born," including the cost of potential health issues related to not having adequate prenatal care.
The Legislature's prenatal plan appears to be very similar to an exemption for domestic abuse already allowed in the Medicaid program.
The Legislature's program allows women to appeal to HHS for prenatal care paid for with this pot of money.
HHS staff did not have numbers available Thursday on how many women have used that exemption.
Senators said this year's small program is not the final word.
A broad committee, with members of both the Judiciary as well as the Health and Human Services committees, will gather information on what happens to women who lost coverage and develop ideas for broader prenatal coverage, said Lincoln Sen. Kathy Campbell, the legislative leader on the issue.
Senators will have time this summer and fall to thoughtfully come up with a plan for providing care to more low-income women, she said.
But in the meantime the state is "not going to protect unborn children for at least a year," the same children the state has protected for the last 20 years, said Omaha Sen. Heath Mello.
"This issue cannot go away," he said.
The prenatal care plan was added as an amendment to another bill (LB507) that dealt with domestic violence issues.
Senators gave a voice-vote second-round approval to the bill before adjourning for a long holiday weekend. They return Tuesday.
