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Bill would expand prenatal care for Missouri's poor

Missouri lawmakers Tuesday renewed efforts to establish a program that would extend prenatal health coverage to more low-income women.

The Show-Me Healthy Babies program, sponsored by Rep. Jeff Grisamore, R-Lee’s Summit, would expand the state’s Children Health Insurance Program to cover services for the unborn children of pregnant women up to 300 percent of the federal poverty line.

A similar measure passed out of the House late last session as part of a larger package, but it failed to receive a hearing with the Senate Government Accountability and Fiscal Oversight Committee.

“We know from research that with prenatal care health outcomes and quality of life are going to increase for mother and baby and reduce costs to the state,” Grisamore said.

The House Children, Families and Persons with Disabilities Committee held public hearings on two versions of legislation for the new program — one as the House passed it last session and another with amended language from the Senate.

“Because of the importance and priority of this legislation, we wanted to have two vehicles moving,” Grisamore said.

Rep. Genise Monticello, D-St. Louis, raised the only concern from committee members. She wanted to extend the time period that mothers could be identified as needing treatment for postpartum depression from 60 days to a year and provide coverage as long as treatment was necessary. She said the services for mothers after birth were “crucial.”

Coverage would not include “services that are solely for the benefit of the pregnant mother… unrelated to maintaining or promoting a healthy pregnancy, and that provide no benefit to the unborn child.”

In 2002, President George W. Bush and the Department of Health and Human Services approved new rules that allowed states to include coverage for unborn children in their CHIP programs, which receive federal matching grants for about 75 percent of the costs. At least 15 states have expanded their programs under the rule.

“This is something that we probably should have been at the leading edge of… but I definitely hope we can get it done this year,” Grisamore said.

Representatives of Missouri Right to Life, the Missouri Catholic Conference and the March of Dimes registered their support of the legislation for the record but did not expand on why they supported the measure. No one on the committee or from the public opposed it.

“This is a good way to make sure unborn children from early in pregnancy get coverage,” said Samuel Lee, director of Campaign for Life Missouri, who testified in favor of the bill.

“From a pro-life perspective, the mother gets all of the prenatal services she needs, so that does not have to be a reason to get an abortion,” Lee said. “There is no disagreement, no matter your ideological persuasion, to carry a child to term, the mother needs prenatal care.”

The fiscal note estimates the program would cost about $2.9 million in fiscal year 2014 and more than $3.5 million in 2016 and 2017. The new program would apply to about 1,800 pregnant women between 185 and 300 percent of the federal poverty line.

Pregnant women at or below 185 percent of the poverty line are already covered by Missouri’s Medicaid program, which includes medical services other than just those related to pregnancy. The fiscal note based its conclusion on the costs of treating these women at $579.11 per month per individual.

The committee also considered a bill that would remove references to the phrases “mentally retarded” and “mental retardation” from statutes and replace them with “intellectually disabled” and “intellectual disability,” but there was still uncertainty about whether the semantics change would impact federal funding.

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