Health Care Reform Links

Here are some quick links for today about the health care reform debate.

One of the primary concerns about the House version of the health care reform bill is whether it would do anything to contain the cost of medical care.  According to a major new study, it would.

But the Senate is working on its own compromise, because there are not enough votes for a bill like the House's bill.  What does the House bill have that the Senate can't agree with?  Two words: public option.

But the Senate is close to its own version of the bill.  Will that version save money as well?  Maybe, but we don't know yet.  There are still a lot of unanswered questions about what the Senate is working on.

One thing's for sure: even if a bill passes, the political debate surrounding its policies is unlikely to end.

Midwives Fighting Crime?

Midwives Fighting Crime?

Writing in Newsweek, Mark Kleiman notes that a program to “send nurses into the homes of poor and undereducated first-time teenage mothers to coach them through their children's difficult first two years” has had an unexpected benefit: the kids cared for under this program are less likely to commit crimes.  That’s right: in addition to improving maternal and child health, intensive one-on-one care from a nurse is responsible for a broader social good.

Sounds like a good program that should be expanded.  And indeed, this program is set to be expanded in the health care reform bill currently before Congress.

But there’s a shortage of nurses in the U.S.  Where do we find the caregivers?  Why not Certified Professional Midwives (CPMs), who provide a similar service.  If CPMs were reimbursed under Medicaid, they could do a lot of good for mothers, babies, and, as it turns out, for society at large.  How about it, Congress?

Congress takes an important step forward for CPMs!

MAMA’s hard work, with your intrepid support, is paying off!  The Senate Finance Committee has included language in their bill that will advance the interests of CPMs and the women they serve - thanks to the support of a key Senator secured by MAMA!

On Friday, November 13th, MAMA representatives met with a top health aide to Senator Maria Cantwell from Washington State.   In direct response to MAMA advocacy, Senator Cantwell has included a provision in the Senate Finance Committee bill that will require Medicaid to reimburse licensed birth attendants (which would include state-licensed CPMs) who provide services in licensed birth centers.  We were told that the Senator feels strongly about including CPMs in the health care bill and recognizes that her home state of Washington has played a leading role in demonstrating the high quality and low cost of CPM care. The Senator has heard the call from MAMA loud and clear and committed to finding a way to move the ball forward for CPMs. 
    
      Building from language crafted by the American Association of Birth Centers for legislation that will require that birth centers receive payment for facility fees, Senator Cantwell was able to add language specifying payment to the providers - licensed birth attendants - as well.  Other Finance Committee members, including the Chairman, lined up with Senator Cantwell in support of her provision, demonstrating that our outreach to those offices has also borne fruit.  Of great significance, she has also secured the commitment of Senator Reid, the Democratic Majority Leader at the center of crafting the final health care bill this year, to keep her language in this year’s final bill.  Inclusion of this language represents a significant commitment on the part of the Senator, and we are very grateful to her for this important step forward for CPMs and for expanded choice for women and families!

     As a key member of the Senate Finance Committee, Senator Cantwell has a limited number of initiatives that she can champion herself, but she has offered to fully support any other Senator who will file MAMA’s original provision on the floor of the Senate to require that Medicaid reimburse all CPMs in all settings. 

     We are proud of and grateful to all of the midwives and mothers in action in Washington State for the successful outreach to their Senator!  And we are grateful to all of you who have helped to secure the wide support that the MAMA Campaign and CPMs enjoy in the Senate!

     The provision included in the Senate Finance Committee bill will provide a strong legislative platform for further action to secure access to CPMs for all childbearing women, both in the current health care bill and in the years to come.   It is interesting to note that a number of states have first secured just a portion of their initial legislative “ask” , and then  accomplished their original goal in a subsequent year.  In New Hampshire, for example, the midwives went to the legislature to mandate that all insurance carriers in the state reimburse the licensed midwives.  That year, a mandate was passed that only reimbursed midwives operating out of licensed birth centers.  The following year, the midwives were successful in having the mandate expanded to cover all licensed midwives offering services in all settings. 

What is next for MAMA this year?
     MAMA remains committed to including our original provision to mandate Medicaid reimbursement for all CPM services, regardless of site of birth, in the health care bills this year!  We are in negotiation with Senate Finance Committee offices in the effort to secure a champion to file our amendment on the floor of the Senate.  In addition, we have a strategy to leverage our support in both chambers to include our provision in the final bill that will be signed by the President, whatever the outcome in the Senate.  


Caption: "Thumbs Up to CPMs! Brynne Potter and Mary Lawlor in Wshington DC

Join Us for a Webinar on December 3rd to Learn All About These New Developments.

Our federal lobbyist, Billy Wynne will join representatives from the Campaign Steering Committee, on Thursday, December 3rd, for an exciting webinar about the MAMA Campaign at 8 pm EST.  Please note that this is a new date.  The webinar was previously scheduled for the beginning of Thanksgiving week, but that week was too busy for too many of our supporters so we have postponed the date a week to accommodate our supporters.

You are invited to join us to hear:

• What this new language in the Senate bill will mean for midwives and mothers across the country
•  About the most successful fundraising campaign for midwifery ever!
•  What the next steps are this year for Federal recognition for CPMs

It is easy to participate in the webinar!  Click here to register and receive easy steps to join us.

And during the webinar MAMA wants to answer your questions:  email a question to info@mamacampaign.org and put “Webinar Question Submission” in the subject line. We look forward to your participation!

 

How about a little more?

According to the Congressional Budget Office, the just-unveiled Senate health care reform bill will reduce the deficit by $127 billion.  (http://www.nytimes.com/2009/11/19/health/policy/19health.html?_r=1&hp)
 
Certified Professional Midwives who practice in birthing centers are already part of the savings.  (http://www.mamacampaign.org/mama-updates/)
 
But how about saving just a little bit more money, and letting ALL CPMs, no matter where they practice, into the bill?  How about it, Senators?

We Can Fix This One

9lb full term baby born at home with CPMsA major Centers for Disease Control (CDC) report came out this week on infant mortality in the U.S., and its findings are pretty clear: the U.S. has bad infant mortality statistics because too many babies are born prematurely.  And why are too many babies born prematurely?  There are many reasons, but one of them appears to be that doctors are pushing induction and caesarian section on women.  According to the author of the report, statistician Marian MacDorman, “Fifteen or 20 years ago, if a woman had high blood pressure or diabetes, she would be put in the hospital, and they would try to wait it out. It was called expectant management.  Now I think there’s more of a tendency to take the baby out early if there’s any question at all.”

The sad part about this is that the U.S. is really good at taking care of premature babies.  Premature babies born in the U.S. are “more likely to survive” here than elsewhere, but we just have so many premature births that our infant mortality rate is worse than countries where the care for premature babies is not as good.

According to the study, “If U.S. infants were as mature as Sweden's are at birth, nearly 8,000 infant deaths could be avoided and the U.S. infant mortality rate would be about one-third lower than it is.” Poverty is also a major factor, as is a reliance on fertility drugs, which often result in riskier multiple births. 

It sounds like we need to find a source of low-cost maternity care that encourages bringing babies to full term.  And hey, we’ve got one: Certified Professional Midwives.  Midwives are ready and willing to answer the call, if the federal government will just recognize us.