Today I’m turning my blog over to Kate Shamszad, MS, MPH, who is a Senior Program Officer in the Quality Institute’s Medicaid Policy Center. The Medicaid Policy Center delivers independent research, analysis, and policy solutions to improve health outcomes while also controlling health care costs.
New Jersey is stronger when we can all make decisions about our families, our health, and our futures, and live and work with dignity. All of us should be able to plan when and if to have children and raise the children we have with dignity and respect in supportive communities. When we ensure that everyone — regardless of income, zip code, insurance coverage, or immigration status — gets affordable and high-quality health care, the health and well-being of our community — and our state — improves.
The evidence is overwhelming that high-quality comprehensive pregnancy-related care leads to lower infant mortality and healthier babies. The fiscal benefits are significant in the short term and the long term. And the human benefits are incalculable.
New Jersey policymakers recognize the value of contraceptive access, as evidenced by their investment in family planning in the state budget. It is also clear that they value prenatal care, seen in their creation of the Supplemental Prenatal Care program two decades ago to extend funding to increase access to prenatal care for people who are undocumented in New Jersey. The program provides free or low-cost prenatal services at hospital clinics and FQHCs.
But here’s the problem. Since 1999, the program’s funding has been capped at $3.8 million. During that time, the medical component of the Consumer Price Index has increased by nearly 230 percent. Not surprisingly, funding generally runs out four months into the fiscal year. Once the money is gone, hospitals and FQHCs may continue to provide services as Emergency Assistance under charity care, but only a small portion will be reimbursed.
As a state, we recognized the fiscal and public health benefits of providing adequate prenatal care to everyone delivering babies in New Jersey. The children born in our state to individuals that are undocumented are American citizens and New Jersey residents, and as a result they can be enrolled in the state’s Medicaid program. We have a moral imperative to do all we can to support healthy pregnancies and avoid new babies needing to be in the NICU. Moreover, our actions would save taxpayer dollars at a rate that more than pays for the cost of the prenatal care. In an infant’s first year alone, every $1 invested in prenatal care saves $3 in health care costs. More important, giving every child born in our state the healthiest start in life pays off for generations to come.
We know that the babies born to individuals covered under Emergency Assistance with little to no prenatal care have a much greater rate of admission to NICUs than the Medicaid population at large. Moreover, some of these most serious cases require lifelong specialty care, costs borne by the state’s Medicaid program.
The current budget for the Supplemental Prenatal Care program is simply not working — not for parents, babies, or taxpayers. Prenatal care is low-cost health care and an investment we should make in our community. Skimping on investing in health care for the 7,500 people who are currently not eligible for Medicaid due to their immigration status and who give birth each year leads to expensive medical costs after delivery and for years to come and contributes to the disgraceful disparities in maternal-child outcomes in our state.
The Reproductive Freedom Act NJ (S3030), which was recently introduced and formally endorsed by the governor, contains many provisions to improve access to care including expanding the Supplemental Prenatal Care Program to cover the full range of reproductive health care, including contraceptive, abortion and pregnancy-related services for New Jerseyans who do not have a path to Medicaid or insurance coverage. It’s the right investment for a state that is committed to healthy families.
We have seen first-hand that outcomes are best when pregnancy-related care focuses on physical health as well as the social and emotional health of the pregnant individual. In the Trenton area, partnerships between Capital Health and many community partners, including the Children’s Home Society and Trenton Health Team, offer comprehensive care to people who are undocumented even after funding from the Supplemental Prenatal Care Program has ended — and the outcomes for the parents and babies receiving this care are equal to those receiving managed Medicaid for the duration of their pregnancy.
As we’ve shared, in addition to prenatal care, reproductive health care has to be part of the equation — it is as essential for all families, regardless of immigration status, to determine when to bring a child into the world, a decision that is supported by this bill. And every $1 invested in family planning programs, which includes contraceptive care saves the federal and state governments approximately $7 in related costs down the line.
When New Jerseyans can access comprehensive health care — and when they have the ability to make decisions about their reproductive health — they are more likely to have healthy babies, improving the health of our next generation and the overall health of our state. And it isn’t a huge financial lift. Fully funding this program should be, at a minimum, budget neutral. As we move rapidly toward budget planning for Fiscal Year 2022, we urge the state to consider this program and increase the appropriation so that all pregnant individuals, regardless of immigration status, get the care they need and deserve.