George Hill: Increasing Medicaid coverage for women good for families


At a rally in January, Gov. Paul LePage stated that outlawing abortion is the solution to Maine’s declining population. Apparently, he believes that forcing women to have children they are not prepared to parent is key to a prosperous future.

This is an interesting approach, considering the many ways LePage has made it harder for low-income women to get the help they may need to raise their children – ending Medicaid eligibility for more than 14,000 low-income parents, setting time limits for TANF, cutting General Assistance funding, and vetoing an increase in the minimum wage.

Gov. LePage’s policies have made this state a much more difficult place for poor women to raise their children.

When women are forced to have children they are not emotionally or financially prepared to raise, the negative effects multiply through the years, both for families and for Maine. Poverty, hunger and the resultant unhealthy family settings have lifelong repercussions for a child’s health and his or her ability to learn and thrive. Families who have children resulting from unintended pregnancy are far more likely to rely on Medicaid and other social supports, at great cost to our taxpayers.

Most Mainers agree that it is best for everyone when babies are born into healthy, stable families that are ready and able to give them what they need. How do we do this? By ensuring that everyone has access to health care, including family planning services.

In the coming weeks, Maine has two opportunities to increase access to health care, including family planning services, for mothers and future mothers, at very little cost to Maine’s taxpayers.

First, Maine’s Legislature will decide whether to accept federal funds under the Affordable Care Act to provide Medicaid coverage to thousands of uninsured Mainers. This would provide health care for more than 14,000 parents, mostly mothers, who lost Medicaid coverage in January, and another 45,000 uninsured Mainers. Federal funds will cover 100 percent of the cost of this coverage for two more years, after which the state’s share will gradually increase to 10 percent.

Maine’s Legislature also has an opportunity to expand access to family planning services for thousands more uninsured women by enacting a Medicaid Family Planning option. This would provide Medicaid-funded family planning services for women who make too much money to qualify for full Medicaid coverage, but cannot afford private insurance.

Women living under 200 percent of the federal poverty level — about $39,000 for a family of three — are five times more likely to experience an unintended pregnancy than women with higher incomes. The biggest reason for this is lack of access to quality family planning.

When women at this same income level become pregnant, they are automatically eligible for full Medicaid coverage. By helping these women avoid those pregnancies that are unintended, Maine will save more than $5 in Medicaid costs for every dollar invested.

Expanded access to Medicaid family planning services will reduce Maine’s Medicaid costs within the first year of implementation. The 30 states that have enacted this Medicaid Family Planning option have experienced reductions in Medicaid costs as well as lower rates of unintended pregnancy and abortion.

Giving couples access to the health care they need in order to delay parenting until they are ready improves outcomes for families, improves the health and well-being of children, allows women to advance their education and careers so they can better support their families, and saves millions of dollars in Medicaid costs. And the benefits magnify for future generations.

A recent study by the University of Michigan found that ensuring access to family planning services increases family incomes, reduces rates of child poverty and increases kids’ odds of graduating from high school and college.

Women who have access to health care during pregnancy and after their children are born are better able to care for and support their families. Women who don’t have health insurance receive fewer prenatal health care services and are more likely to experience adverse outcomes, such as pregnancy-related hypertension, low birth weight and infant mortality.

Beyond prenatal care, uninsured women are more likely to be diagnosed with late-stage cancers, more likely to die from cancer or cancer complications, and more likely to experience a host of other negative health outcomes.

A recent study found that one in four American women said they had gone without needed health care because they could not afford it. That is no way to create a prosperous future for Maine’s children.

Maine kids need healthy moms, and Maine moms need health care coverage to make that happen.

Increasing access to health care through Medicaid will result in healthier women and families, lower Medicaid costs, and fewer abortions in Maine.

That is a solution everyone, even Gov. LePage, should happily embrace.

George Hill is president and CEO of the Family Planning Association of Maine.