Recently, I wrote about Danielle Deaver, the Nebraska woman who was denied an abortion after her 22-week fetus was deemed unviable. Instead of being permitted to terminate her pregnancy, Deaver was forced by state law to endure “10 excruciating days” waiting for the extremely premature fetus to be born.
The Deavers were victims of Nebraska’s ill-conceived “fetal pain” law which prohibits abortions in the state after the 20th week of pregnancy. It is based on the discredited notion that a fetus may feel pain at that stage of development. Physicians who break the law face felony charges that could result in five years in prison and a $10,000 fine.
At the time, the author of the Nebraska law, Speaker Mike Flood, a Republican, said that even though the infant gasped and suffered for fifteen minutes before dying, he felt confident that the statute worked as planned in the Deaver case:
"Even in these situations where the baby has a terminal condition or there's not much chance of surviving outside of the womb, my point has been and remains that is still a life," Flood told the Des Moines Register.
Well, it turns out that the sanctity of life is not applicable in all cases in Nebraska. Last year the state passed a different law that eliminated Medicaid funding for prenatal care for about 1,600 low-income women, about half of whom were illegal immigrants. Doctors and health clinic administrators told the Lincoln Journal Star, that this cut in funding has had “dramatic effects.”
“At least five babies have died. Women are traveling 155 miles to get prenatal care. Babies have been delivered at clinics, in ambulances and hospital emergency rooms.”
The Journal Star continues;
“Andrea Skolkin, chief executive officer of One World Community Health Centers in Omaha, said that in the past year, only about half of uninsured women are receiving any prenatal care. The health center has more premature births to uninsured women, compared to insured women. Uninsured mothers were twice as likely to deliver through cesarean section, which is more expensive.
“At the Good Neighbor Community Health Center in Columbus, the number of female patients has doubled, and the income for the prenatal program has dropped drastically, said Rebecca Rayman, executive director. Women are coming to the center from 22 counties"
Meanwhile, the article adds, “Four infants died in utero at the Columbus health center”, according to Rayman. “In the previous seven years, the clinic had never had an in utero death.”
According to a post on the blog The Wonk Room: “In 2010, a local newspaper reported that at least seven women in Nebraska had abortions because they couldn’t afford the cost of prenatal care since the state stopped paying for it.”
This maddening hypocritical stance taken by the state—staunchly pro-life unless it’s a poor or illegal immigrant life, has not escaped the notice of public officials or abortion foes. Another post on Wonk Room reports that Nebraska state Sen. Kathy Campbell (R) recently introduced a bill that would reinstate the prenatal care–although it’s unlikely to pass in this session.
Opposition to Campbell’s bill taps anti-immigrant sentiment in the state, according to the post: “‘Our position is that we shouldn’t be spending any money for people who are here illegally,’” stated Vivianne Chaumont, director of the state’s Medicaid division who testified in opposition to the bill.” A close look at the new policy reveals that although Nebraska’s Medicaid considers an “unborn child” to be ineligible for Medicaid coverage, the program will pay for costs of delivery and any emergency complications that arise at birth. Dr. Caron Gray, from Creighton University Medical Center called Chaumont out on the issue of cost savings, stating, "‘We can sit here and talk about costs as much as we would like, but I think we really need to be honest about what this is truly about … political beliefs and standing on what to do with immigration.’”
The Century Foundation Fellow Harold Pollack wrote about the Nebraska prenatal care policy in his post “We Asked for Workers, but They Sent Us Men (and Women, Too)” on Taking Note earlier this week:
“Because of such policies, many women left uninsured must travel great distances to receive care. The cost of such care is then absorbed by safety-net providers willing to treat them. Many of the affected women receive no prenatal care at all. Several babies have apparently died in this group. I can’t really tell from the story whether the new policy is to blame for these deaths. I can say such bullying policies are a disaster for Nebraska’s maternal and child health system.
“During the 1980s, Henry Waxman and other policymakers realized that one couldn’t promote the health and well-being of pregnant women or their children while millions of pregnant women went uninsured. Nor could one have an effective and properly financed maternal and child health system when labor and delivery was the largest single item of uncompensated care.
“Prenatal care is the gateway to almost every essential intervention during the relatively short period of pregnancy. When women don’t present for care until very late in pregnancy, perhaps during active labor itself, there is little opportunity to address poor maternal nutrition, gestational diabetes, maternal tobacco use, sexually-transmitted infections, genetic issues, domestic violence, and more. It’s even difficult to carefully plan the logistics of the delivery itself. So many women, their families, and their providers have a more harrowing, sometimes dangerous experience than needs to occur.
“Such financial and delivery-system realities led to the Medicaid eligibility expansion of the 1980s and early 1990s, one of the most admirable and successful health policy initiatives in recent decades. Responding to the real and alleged problems associated with undocumented immigrants, and responding to Medicaid budget challenges that affect many states, states such as Nebraska are tarnishing this admirable record by enacting punitive measures." [In Wisconsin, for example, Governor Scott Walker’s new budget also includes a proposal to eliminate Medicaid coverage of prenatal care for illegal immigrants. This follows Walker’s earlier decision to end the Medicaid program providing contraceptives to low-income women and men and his elimination of all state funding for family planning services (Title V). NF]
Pollack concludes; “The infants born less healthy than they could be, under more difficult circumstances than need be, are American citizens. They deserve better. So do their families, who are here contributing to our society and to our economy. Everyone in America deserves better, too. For many practical reasons, these policies are foolish and counterproductive.