Ohio may be first state to deny pregnant women healthcare

Governor Kasich may become the first elected official in the nation to eliminate healthcare coverage for low-income pregnant women since the passage of the Affordable Care Act.

Beginning in 2014, the law made millions of low-income Americans eligible for healthcare through Medicaid, and, as a result, over 450,000 more Ohioans now have coverage. 43 states expanded Medicaid eligibility to low-income pregnant women in 2014. But pregnant women in Ohio didn’t have to wait for expansion to see their coverage options increase. In 2007, the state, under then-Governor Strickland, expanded eligibility for pregnant women making up to 200 percent of the poverty level.

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Now, Kasich is proposing to reduce that to 138 percent, forcing thousands of low-income women to go without coverage or purchase it on the private market. But monthly premiums and cost-sharing can make private coverage unaffordable for many women, and short enrollment periods can mean women can go months of their pregnancies without coverage.

At least five other states have made moves to reduce eligibility for the program since 2013, but none have ultimately enacted policies that made women ineligible for healthcare during pregnancy. Ohio may be the first.

Beginning in 2014, Louisiana and Oklahoma lowered the income level for women to be enrolled in Medicaid. But, in part due to the fact that women who become pregnant outside of the 3-month open enrollment period will be unable to purchase insurance on their own, the states moved these women into children’s healthcare programs instead. As a result, women will see their unborn babies benefit from prenatal care, while losing coverage themselves after childbirth.

Proposals this year in North Carolina and Maryland to reduce eligibility for pregnant women were defeated in the wake of widespread opposition among healthcare advocates and legislators, many of whom noted the plan would reduce prenatal care and undermine recent improvements in both states’ infant mortality rates. Access to prenatal medical care is directly linked to infant survival.

Currently, Ohio and Connecticut are the only states where cutting Medicaid for pregnant women remains in play. In Connecticut, Governor Malloy’s proposal was removed from the legislation by the Appropriations committee, but final negotiations are ongoing. In Ohio, the House retained Kasich’s proposal and the cuts remain in the bill as pending before the Senate.

Ohio is one of the worst states in the nation for infant mortality, ranking 43rd, ahead of only Oklahoma, Delaware, South Carolina, Louisiana, South Dakota, Mississippi and Alabama in the rate of infant deaths. The state’s rate of infant deaths is significantly higher than the nation as a whole, and is only slightly below where it was a decade ago. Governor Kasich has made infant mortality a centerpiece of his administration’s priorities. Eliminating a vital source of healthcare for low-income women, many of whom will be ineligible or unable to purchase insurance on their own, is contrary to this goal and won’t help the state’s women and babies.