Since the average cost of having a baby today is over $8,800, access to affordable, quality, comprehensive health care is a critical component in a woman's decision whether to parent a child. Also many medical conditions are aggravated by pregnancy including sickle-cell disease, heart disease, diabetes, asthma and high blood pressure, so for a woman with these and other conditions, the costs can be far higher.
Women of reproductive age (15-44) are the most likely of any demographic group to lack health insurance. Medicaid, a federal and state program that provides health insurance for certain low-income individuals, helps fill that gap. Approximately seven million women of reproductive age rely on Medicaid; and women comprise 71% of the program's adult insurees. Medicaid helps guarantee that low-income women have an equal right to health care and the ability to control their reproductive destiny.
Through Medicaid, women can access a wide range of services including pregnancy-related care, preventive screenings, and diagnosis and treatment of chronic illnesses including breast and cervical cancer and HIV/AIDS. Medicaid currently pays for over one third of all births in the United States.
Although the federal Medicaid program does not cover abortions except in rare circumstances [see The Hyde Amendment Violates Reproductive Justice and Discriminates Against Poor Women and Women of Color], this insurance program is an important source of funding for family planning services. Voluntary, accessible family planning services allow women to decide whether to parent or not parent a child, how to control their reproductive and economic lives, and how to make informed decisions about maintaining and improving their health by
(1) allowing for early detection of disease through regular health screenings;
(2) spacing the birth of children in order to improve health care outcomes for both mothers and children;
(3) avoiding economic oppression caused by unintended pregnancies, and/or high-risk pregnancies;
(4) facilitating women's choices about staying in the workforce or completing their education.
Twenty-six states now offer family planning services to low-income women who are ineligible for Medicaid. Every other state can and should offer these services to allow all low-income women to freely determine their own reproductive destiny.
One growing challenge is finding providers who accept Medicaid. As one health policy expert said, at some point a Medicaid card becomes a hunting license. Provider reimbursement must be adequate to guarantee Medicaid patients equal access to a full range of providers and services, including reproductive health care.
A recent requirement for proof of citizenship when applying or reapplying for Medicaid has also created obstacles to care. Adopted under the guise of preventing undocumented immigrants from accessing Medicaid, the impact of this ill-advised rule has been borne overwhelmingly by Americans who lack the necessary documents, such as a birth certificate or passport, to prove their citizenship status.
Medicaid funding is under constant political attack. As Medicaid grows to be a larger portion of state and federal budgets, protecting and preserving program funding and benefits proves to be a bigger challenge. We must ensure that adequate funding of this critical program remains a top priority.