As the nation’s media remain thoroughly
transfixed by health care reform and battles over expanding health coverage,
containing costs, wild allegations about death panels and the like,
H.R. 3200, the House’s version of health care reform, currently ordered to be reported (amended) by voice vote, remains a solid piece of legislation.
And I’m not referring to the fact that
with over 1,000 pages, it weighs in at over 13 pounds. America’s Affordable
Health Choices Act is our best bet for bringing high-quality affordable
health care to all Americans. Yes, it requires much up-front cost, but
it has rational mechanisms for funding its provisions, including savings
realized from a better way of doing health care.
Connection, the national
organization advocating high quality evidence-based maternity care for
all women, babies and families, has thrown its support behind H.R. 3200
because it takes a big step toward widening access to evidence-based maternity care that is safer and more effective than the prevailing
style of care most pregnant women experience today.
Maternity care is big business. Childbirth
is the number one reason for being hospitalized, and maternal and newborn
charges are the runaway leader in hospital charges: $86 billion in 2006
($39 billion of which was publicly funded by Medicaid). A major problem
is that costly childbirth procedures that entail risk are being overused,
wasting precious health care resources. Meanwhile, proven methods, generally
safer and cheaper, aren’t being used enough. Perverse incentives that
encourage overuse of inappropriate procedures have contributed to the
sad fact that while per capita health expenditures in the U.S. far exceed
those of all other nations, our performance lags distantly behind other
developed nations on quality indicators including low birthweight, c-section
and maternal death rates.
H.R. 3200 addresses many of the problems
inherent in the U.S. maternity care system through private insurance
system reforms, better access to primary maternity care, especially
in underserved communities, and improved coverage for prevention and
wellness services. This makes perfect sense considering that most childbearing
women and their fetuses/newborns are healthy and at low risk, and thereby
best served by safe, low intervention primary maternity care, which
offers better value for payers over present approaches.
This legislation also goes a long way
toward achieving Childbirth
Connection’s eight steps to reform maternity care and helps ensure that all pregnant women and
babies receive high quality maternity care.
In particular, the bill would:
1. Prohibit the use of pregnancy as a
pre-existing condition by health insurance providers.
2. Widen access to certified nurse-midwives
by eliminating inequities in how they are reimbursed under Medicare;
3. Measure and report publicly the performance
of maternity care facilities and providers and use results to improve
4. Pay for home visits by nurses for families
during or after pregnancy by Medicaid;
5. Expand access to primary maternity
care by improving Medicaid coverage of freestanding birth centers;
6. Provide incentives to maternity care
providers under Medicaid to provide care to underserved women and their
Kudos to the leadership of the House
Energy and Commerce Committee for passing H.R. 3200. Let’s work to
make health care reform become a reality, finally.