By Carmen Hooker Odom
A baby whose birth is planned is more likely to have a good life, but close to half of all North Carolina pregnancies are unplanned.
That number is even higher for low-income women, with three out of five births unplanned.
Reducing that number is the goal of a Medicaid family-planning waiver that will go into effect October 1.
All women and men ages 19 to 55 with incomes at or below 185 percent of the federal poverty level, or $1,979 a month for a family of two, will be eligible to receive free family-planning services through this program.
This waiver is the result of a partnership that includes nonprofits, local health departments and private providers that work to improve children’s health, the medical community and government, which manages the Medicaid program.
The General Assembly saw the worth of this proposal, approving it in its 2000 session. Other states, including several of our neighbors, already have such programs.
The idea behind this waiver is that if a low-income woman is able to get family-planning services, fewer pregnant woman and their children will need Medicaid services.
Planning for a birth will also result in healthier outcomes.
For instance, a woman who intends to get pregnant can make sure she is getting adequate folic acid to prevent spinal cord defects.
The number of premature and low-birth-weight babies will be reduced. And moms who space their births more carefully will also be healthier.
This program is a win-win for all involved. The ultimate result will be healthier North Carolina families.
The waiver builds on other efforts that we have undertaken to improve the health of low-income North Carolinians.
For instance, the Baby Love program has helped to dramatically reduce infant mortality among Medicaid recipients from 14.9 per 1,000 live births in 1987 to 8.6 in 2000.
A number of family planning services will be covered under the waiver, including:
- Family-planning initial or annual examinations
- Family-planning counseling
- All FDA-approved and Medicaid-covered methods of birth control
- Tubal ligations and vasectomies
- Lab tests in conjunction with family planning visits, including STD/HIV screening tests, pregnancy tests and Pap tests
- Antibiotics for STDS detected during a family planning initial or annual examination
- Referral to a primary care physician or clinic.
Highest priority for these services will go to post-partum women, especially those who have already experienced a problem delivery like an underweight baby.
Four thousand women and men will receive services during the first year. By year five, 20,000 North Carolinians will be served annually.
This waiver is going to do a whole lot of good in North Carolina and it is budget neutral: It won’t cost more tax dollars.
Evaluation of South Carolina’s program, which began in 1993, shows that savings from averted births exceeded the cost of expanded family planning.
Every state that has adopted this approach has had the same budget-neutral results.
This waiver is yet another example of how much better prevention efforts are for both the person and the bottom line.
Carmen Hooker Odom is secretary of the N.C. Department of Health and Human Services.