Whether the Missouri General Assembly will opt into the Medicaid expansion, try another tack, such as reform of Medicaid, or simply do nothing, remains a mystery as the 2013 session nears its halfway point.
One idea under discussion is to cut Medicaid health coverage for pregnant women with the assumption that these women will be able to buy affordable insurance through the newly created exchanges created pursuant to the Affordable Care Act. Right now pregnant women are eligible for Medicaid health coverage with incomes up to 185% of the Federal Poverty Level (FPL). One idea would be to cut the eligibility to 133% of FPL.
But not so fast, say some observers. In an analysis of this issue, two attorneys with Legal Services of Eastern Missouri, Joel Ferber and Amanda Schneider, express concern that the premium pregnant women will have to pay will be too high. They report that a pregnant woman in a family of three with an income of 150% of FPL could have an annual premium as high as $1,099. This could be a challenging premium to pay for women whose household annual income is $29,295.
Another and potentially more serious concern is that there is a three-month enrollment period each year to obtain health coverage through the insurance exchange. But what if a woman gets pregnant at a time outside the enrollment period?
In a recent statement on Medicaid, the Missouri Catholic Conference (MCC) urged legislators to continue to provide “robust health coverage for pregnant women and their unborn children.” The MCC noted that prenatal care promotes healthier outcomes for both mother and child and may encourage women to choose life over abortion.