World-Herald editorial: Thirty votes are needed on prenatal care bill

Whether on health grounds or financial grounds, it makes eminent sense for Nebraska to cover the cost of prenatal care for low-income women, including those who are not U.S. citizens.

Consider the findings in a study published in the Journal of Obstetrics and Gynecology. When undocumented women in California received no prenatal care, they were nearly four times as likely to deliver low-birth-weight babies. And those mothers were more than seven times more likely to deliver premature babies.

Now consider Nebraska numbers. In 2007, two-thirds of Nebraska babies who died during their first year were marked by a specific factor: low birth weight. Such babies are at greater risk of disabilities that can have far-ranging effects on their school performance and their adult lives.

Society, in short, has a crucial interest in encouraging prenatal care. Such care reduces the chances of low-birth-weight deliveries. Such care is good for the baby, good for the mother and good for society.

That’s why Douglas County has rightly been devoting great attention to seeing that all low-income women in the county receive prenatal care, as noted in a Midlands Voices essay last week by two leaders in Douglas County government.

Some argue that Nebraska would save money by denying prenatal coverage to these women. But look at the actual numbers: Once these mothers go into labor, their delivery costs are covered by Medicaid — taxpayer dollars paid by all Americans.

And once these babies are born, they automatically become American citizens under federal law. That means their medical care is then covered by Medicaid — again, taxpayer dollars.

So, do Nebraskans really want to forgo providing prenatal care for these women — and then have to cover the tremendous medical costs for the babies when a sizable percentage of the infants are coping with serious disabilities and illnesses? Do Nebraskans really regard it as proper to deny prenatal care for these women — and then cover the costs for a severely ill newborn on a $2,100-per-day basis in a NICU (neonatal intensive care unit)?

As one testifier recently pointed out to a legislative committee in Lincoln, “one day in the NICU costs more than providing an entire course of prenatal care to an unborn child.”

These key facts completely knock down the mistaken claim, frequently voiced in Nebraska, that denying prenatal-care coverage to these women saves money and looks out for the financial interests of taxpayers.

It’s no wonder, then, that the medical and public health community across Nebraska has spoken loudly and clearly on this issue, supporting prenatal coverage for these women — and it is dismaying that the Heineman administration has remained deaf to what these health care specialists have had to say. On many matters, we find Gov. Dave Heineman to be a capable, skilled leader. But on this issue, we find it inexplicable that his administration would support the denial of coverage for this vital care.

State Sen. Kathy Campbell of Lincoln has shown admirable courage by prioritizing a legislative bill that would provide coverage of prenatal care for these mothers. Her bill, which a legislative committee will discuss this week, warrants approval.

Because the Legislature was notified of this matter in so tardy a fashion, Campbell had to seek a special dispensation from the Legislature in order to introduce her bill after the deadline for filing legislation. To receive that exemption, she needed 30 votes among the 49 senators, and she got it.

She will still need 30 votes to pass the bill, because it includes an “emergency clause” allowing it to take effect soon after its passage.

The vote on Campbell’s legislation needs to be a moment for moral clarity. Senators who in their hearts want to vote “yes” but fear the political consequences need to do the right thing and lend their support to this legislation.

On this issue, it is imperative that swing-vote lawmakers not retreat into the politically safe “not voting” mode. Otherwise, Campbell will never reach the 30-vote mark.

Incumbent lawmakers who are up for re-election or are seeking other offices also have an obligation. They’ll be tempted to take the politically easy way out and vote “no” or not even vote at all. Instead, they should stand up for Nebraska’s best interests and lend support to this bill.

Such backbone is the mark of a responsible leader. Such leaders put the public interests ahead of their personal political interests. Such leadership is needed now, in support of vital prenatal care.

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