Republican legislators aren’t convinced that insuring women will save NC infants’ lives

Providing health insurance coverage to more low-income women could save the lives of about 47 babies each year, Dr. Adam Zolotor, NC Institute of Medicine president and CEO, told legislators Tuesday.

But Republicans in the state Senate were skeptical of the prediction.

An institute task force looking at ways to improve the health of mothers and infants immediately before and after birth recommended the state expand Medicaid to more low-income residents and use the Children’s Health Insurance Program to provide care to immigrant women who are in the country without legal authorization.

CHIP is a government-subsidized health insurance program for children who don’t qualify for Medicaid, usually because their parents make too much money. But women who aren’t in the country legally don’t qualify for most Medicaid services and usually don’t qualify for CHIP, even though their children would be citizens. Using CHIP for their pregnancy care could save the lives of 10 babies a year, the report said.

North Carolina has one of the worst infant mortality rates in the nation; the Perinatal System of Care Task Force put it at 39th in its report to legislators. In 2018, there were 6.8 deaths of babies a year old or younger in North Carolina for every 1,000 births, according to state statistics.

“If we’re serious about infant mortality, if we’re serious about the infant mortality disparity, we think Medicaid expansion is really critical,” Zolotor, a member of the task force, told legislators.

Black infants are more than twice as likely to die before their first birthdays than white infants in North Carolina and the nation, The News & Observer has reported.

The insurance items in the task force report were in a package of recommendations for improving care, community support for pregnant women, and data gathering.

The task force report referenced a study published in 2018 that concluded that the infant mortality rate dropped more quickly in states that expanded Medicaid, with the biggest declines among African Americans.

The study did not convince Senate Republicans who oppose Medicaid expansion.

Sen. Joyce Krawiec, a Kernersville Republican, noted that the steepest drops in death rates in the years referenced in the study were between 2010 and 2014, before states started implementing Medicaid expansion.

“It’s misleading to tie it to Medicaid expansion,” she said.

Sen. Ralph Hise, a Spruce Pine Republican, asked if “putting someone on Medicaid would make them more healthy.”

Zolotor said it’s important for women to be healthy before they get pregnant, but did not have information to show people who have Medicaid are healthier than people who don’t have it.

Zolotor got fewer questions about using CHIP to cover care for pregnant women regardless of immigration status.

Using the Children’s Health Insurance Program would save the state about $4 million, the report said. Zolotor said that “red, blue, and purple states, including Texas, Oklahoma, and Arkansas use CHIP for this coverage.”

The immigrants added to the program would receive full pregnancy coverage, and coverage for labor and delivery. As it is now, two months of care are covered, with emergency Medicaid picking up the cost of labor and delivery.

Sen. Gladys Robinson, a Guilford County Democrat, said she was upset by the state’s high infant mortality rate.

“We ought to be ashamed,” she said. “I am ashamed. We are the ones who are hurting our communities. We have to fund the uninsured. We need to expand Medicaid, without a doubt.”

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This story was originally published March 11, 2020 at 5:30 AM with the headline "Republican legislators aren’t convinced that insuring women will save NC infants’ lives."