Posted on: Friday, September 7, 2001

Island Voices
Insure pregnant women now

By Ivan Lui-Kwan, Walter Tagawa and John Henry Felix

With good will and a little hard work, Congress can accomplish a significant achievement this year: guaranteeing that 99 percent of America's pregnant women have access to health coverage for maternity care.

This provision has broad bipartisan support in Congress and in the states.

In fact, just this month, Gov. Ben Cayetano joined his colleagues at their annual governors' summer meeting by voting unanimously to support this initiative. The governors have asked for this flexibility, and now is the right time for Congress to give it to them.

For us at the March of Dimes, the importance of this bill cannot be overstated.

Nearly one in five women of childbearing age in the United States is uninsured; many of them will become pregnant. In Hawai'i, there are 27,000 women between the ages of 15 and 44 without health insurance. For these otherwise young and healthy women, pregnancy is typically the most expensive medical event they will experience as young adults. What can be done to help them?

It may be that wholesale reform of the healthcare system will take time, but the legislation now pending in Congress includes incremental but important steps to help uninsured pregnant women and newborns.

Specifically, this legislation permits (rather than mandates) states to use federal funds to extend health coverage to approximately 41,000 pregnant women who, each year, meet the State Children's Health Insurance Program (SCHIP) income guidelines. The provision for pregnant women, which has been introduced in several versions in the U.S. Senate and House, would also provide health coverage to newborns.

Importantly, President Bush and Health and Human Services Secretary Tommy Thompson supported improving access to prenatal care. In recent days, numerous proposals to expand access to coverage for pregnant women have been considered. Presidential press secretary Ari Fleischer said it best: "The president's concern is to make certain that there is proper prenatal care."

At the March of Dimes, we couldn't agree more. And the least cumbersome and contentious way of meeting this goal is to make sure states have the option to cover income-eligible pregnant women in their State Children's Health Insurance Programs.

But for the political will to make this legislation a priority, there is simply no good reason why this bill cannot be passed this year.

SCHIP is the only major federally funded program that denies coverage to pregnant women while providing coverage to their infants and children. Covering eligible babies once they are born but denying prenatal coverage to their mothers makes no sense.

We know prenatal care improves birth outcomes and can save money. According to the National Center for Health Statistics, infants born to mothers who receive no prenatal care or late prenatal care are nearly twice as likely to be low birth-weight. In fact, low birth-weight accounts for 10 percent of all healthcare costs for children.

Often, lawmakers are confronted with contentious issues to which there are no easy answers. This is not one of those times. Expanded health insurance coverage for pregnant women with limited family incomes will have a profound — and immediate — impact on improving their health and their children's.

It's worth noting once again. A recent study commissioned by the March of Dimes found that if this provision becomes law and every state were to pick up the option to cover income-eligible pregnant women, 99 percent of all pregnant women in the United States would have access to health insurance coverage.

That's a success story in which we could all take justifiable pride.

Ivan Lui-Kwan is board chairman of the March of Dimes Chapter of the Pacific; Walter Tagawa is board vice chairman; John Henry Felix is board chairman emeritus.