Nevada Medicaid administrator backs prenatal care for low-income women

Providing prenatal care for low-income women is a good idea that can be done without getting into a battle over abortion law, said Nevada Medicaid Administrator Chuck Duarte.

The idea of extending the State Children's Health Insurance Program to "unborn children" was suggested by the Bush administration earlier this month as a way of providing prenatal care to more women who make too much money to qualify for Medicaid and other entitlement programs but don't have health insurance.

The program -- here called Nevada CheckUp -- provides health coverage for children of those who can't afford health insurance up to age 18.

The plan drew protests from women's rights supporters who said they fear the Bush administration was using the proposed regulation change to lay legal groundwork establishing the rights of a fetus and outlaw abortion.

"It undermines the whole premise of Roe v. Wade by giving legal status to a fetus from the moment of conception," said Marcia Greenberger of the National Women's Law Center.

Abortion opponents said they hope the proposal does exactly that.

Duarte said he's staying out of that debate but supports the idea of prenatal coverage for pregnant women who don't fit under other programs.

"All the politics aside, it's a good idea," he said pointing out it would result in more healthy babies and, in the long run, reduce costs of caring for babies who aren't healthy when born.

"It makes good public health sense," he said.

Duarte said Nevada CheckUp already covers prenatal care for women under age 18 who are insured through Nevada CheckUp.

And he said Medicaid pays birth costs for low-income women.

He said extending the program as suggested by the administration would allow the state to cover prenatal care for pregnant women whose children would qualify for Nevada CheckUp after they are born. He said it's not necessary for the state to get into the abortion controversy to do so.

"We don't have to get into that battle. We could do it in a way that's non-controversial," he said. "We'd do it through what's called a waiver and just recognize pregnant women as a covered group in Nevada CheckUp."

Duarte estimated there would be about 300 such births a year in Nevada. The women now receive coverage for birth costs under Medicaid, he said, at an estimated $1,500 per health birth, or about $450,000 a year. Since Nevada CheckUp money is two-thirds federal, the state's share of the total would be about $150,000 a year.

Duarte pointed out $150,000 is a very small portion of Nevada's Medicaid budget, which is $949 million for fiscal 2003.

The only problem, he said, is the tight fiscal constraints facing Nevada in the upcoming budget cycle.

"We're looking at the costs," he said. "However, given the current budget situation, I cannot say whether the enhancement would be approved."