Medicaid Helps Struggling Families Succeed

Since 1980, Maternity Care Coalition has been fighting to strengthen families and inspire change in Philadelphia and its surrounding counties.
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Originally posted on June 20, 2017

Since 1980, Maternity Care Coalition has been fighting to strengthen families and inspire change in Philadelphia and its surrounding counties. We service the most vulnerable communities where the hard working poor and low-income pregnant women and their children face challenges in every facet of their lives. The threat to MCC families’ health and economic well-being has never been greater with the potential repeal of ACA, significant cutbacks to Medicaid and defunding of Planned Parenthood.

A quick snapshot of MCC families overall shows that 98% of our families are at or below the 200% poverty level, which means for a family of 4 the income range is $24,250 to $58,500. Of the 5,000 families, we serve each year, 88% rely on Medicaid or Medicaid expansion for their babies to be born.

One MCC Family explained how the loss of Medicaid would impact their family.

“If we no longer had Medicaid, I’d be devastated and overwhelmed with debt. We see a doctor at several times a month for various reasons (check-ups, follow-ups, specialties, wellness checks, etc.) My boyfriend, my eldest daughter, my son, and I take daily medications. I work part-time from home as a consultant, and my boyfriend’s employer offers health insurance that would undoubtedly bankrupt us and not fully cover the entire family. We would not be able to afford rent or food if we took their insurance. Without Medicaid, I would have never been able to afford critical hospital stays or have regular checkups and vaccines for my kids. The debt would have been extreme, especially with medications on top of the hospital bills.”

Prior to the ACA, pregnancy was considered a pre-existing condition in PA, forcing over 50% of Pennsylvania mothers to be on Medicaid to deliver their babies because they couldn’t afford the high premiums of insurance plans that covered pregnancy or were unable to have any health insurance at all. With ACA, these numbers have been declining. In 2014 39% of 142,000 births in PA were on Medicaid.

Even women who had private insurance prior to ACA were forced to pay out of pocket expenses for a large amount of their maternity care since pregnancy was considered an optional benefit as well as a pre-existing condition. The current estimate for a plan under the American Health Care Act that covers pregnancy in the private insurance market is estimated at $19,000 per year! This puts pregnancy coverage out of the reach of low and middle-income families.

Medicaid expansion has been critical in giving moms health care coverage past their postpartum visit. Prior to its expansion, women on Medicaid due to pregnancy only had coverage in Pennsylvania for 8 weeks postpartum. Many of our families have now been able to transition to Medicaid, giving mother and baby critical healthcare services such as access to birth control, breastfeeding support, and monitoring for post-partum depression, along with monitoring of other chronic health care conditions. Without the ACA, this would end and many women would have no access to healthcare services after 8 weeks.

Women who are covered under Medicaid expansion are more likely to cover their children on CHIP or Medicaid ensuring the next generation’s health and wellbeing. In Pennsylvania, 41% of

children rely on Medicaid or CHIP for their insurance. Another illustration of impact for MCC children is illustrated by this mother’s story:

“Medicaid helped my son when he had to have bi-lateral surgery to open both of his tear ducts and have stents placed in them. During the surgery, doctors discovered how severe his vision was and that he had a crossed eye. Thanks to Medicaid, he will now be receiving glasses so that he will no longer struggle to see and be ready to learn.”

In addition, children with disabilities rely on Medicaid not only for their healthcare but also for services provided during school hours, which would be a $143 million dollar loss to school districts and programs such as Early Head Start in Pennsylvania.

The defunding of Planned Parenthood would strike a particular blow to women’s access to basic healthcare including gynecological services including PAP tests and breast exams. One MCC mother stated:

“Without Planned Parenthood, I wouldn’t be able to access healthcare in my neighborhood including my low-cost birth control which I wouldn’t be able to afford otherwise.”

Defunding Planned Parenthood, Reducing Medicaid or restructuring it to per Capita Caps and repealing ACA essential health benefits and protections for families, jeopardizes critical gains for women’s health and economic security. If as a society we truly value motherhood and children, then we need to start standing up for our families. Repealing ACA and cutting Medicaid is the difference between having the ability to take care of your health needs and landing in paralyzing poverty.