Health Care Reform Will Improve Maternity Care

Maureen Corry

Childbirth Connection has thrown its support behind the House's health care reform bill because it takes a big step toward widening access to evidence-based maternity care.

As the nation’s media remain thoroughly transfixed by health care reform and battles over expanding health coverage, containing costs, wild allegations about death panels and the like, H.R. 3200, the House’s version of health care reform, currently ordered to be reported (amended) by voice vote, remains a solid piece of legislation.

And I’m not referring to the fact that with over 1,000 pages, it weighs in at over 13 pounds. America’s Affordable Health Choices Act is our best bet for bringing high-quality affordable health care to all Americans. Yes, it requires much up-front cost, but it has rational mechanisms for funding its provisions, including savings realized from a better way of doing health care.

Childbirth Connection, the national organization advocating high quality evidence-based maternity care for all women, babies and families, has thrown its support behind H.R. 3200 because it takes a big step toward widening access to evidence-based maternity care that is safer and more effective than the prevailing style of care most pregnant women experience today.

Maternity care is big business. Childbirth is the number one reason for being hospitalized, and maternal and newborn charges are the runaway leader in hospital charges: $86 billion in 2006 ($39 billion of which was publicly funded by Medicaid). A major problem is that costly childbirth procedures that entail risk are being overused, wasting precious health care resources. Meanwhile, proven methods, generally safer and cheaper, aren’t being used enough. Perverse incentives that encourage overuse of inappropriate procedures have contributed to the sad fact that while per capita health expenditures in the U.S. far exceed those of all other nations, our performance lags distantly behind other developed nations on quality indicators including low birthweight, c-section and maternal death rates.

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H.R. 3200 addresses many of the problems inherent in the U.S. maternity care system through private insurance system reforms, better access to primary maternity care, especially in underserved communities, and improved coverage for prevention and wellness services. This makes perfect sense considering that most childbearing women and their fetuses/newborns are healthy and at low risk, and thereby best served by safe, low intervention primary maternity care, which offers better value for payers over present approaches.

This legislation also goes a long way toward achieving Childbirth Connection’s eight steps to reform maternity care and helps ensure that all pregnant women and babies receive high quality maternity care.

In particular, the bill would:

1. Prohibit the use of pregnancy as a pre-existing condition by health insurance providers.

2. Widen access to certified nurse-midwives by eliminating inequities in how they are reimbursed under Medicare;

3. Measure and report publicly the performance of maternity care facilities and providers and use results to improve care;

4. Pay for home visits by nurses for families during or after pregnancy by Medicaid;

5. Expand access to primary maternity care by improving Medicaid coverage of freestanding birth centers;

6. Provide incentives to maternity care providers under Medicaid to provide care to underserved women and their families.

Kudos to the leadership of the House Energy and Commerce Committee for passing H.R. 3200. Let’s work to make health care reform become a reality, finally.

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