Every Republican voted to pass a state budget that won’t add jobs, but will add to the infant mortality rate. It’s simply too Orwellian to call it a “Jobs Budget” when they’re spending a billion dollars to shut down 27,000 jobs.
In 2009, the state government issued a 7-point plan to reduce Ohio’s infant mortality rate. On Thursday, the Ohio House passed a budget which specifically undermines each of those 7 points. If they don’t expand Medicaid, the Pregnancy and Parenting Program will increase Ohio’s infant mortality rate–particularly if family planning is defunded.
Infant Mortality in Ohio
Ohio has the 11th-highest infant mortality rate, and the highest infant mortality rate for African-Americans, in the United States. Higher than neighboring states. Higher among African-Americans than Mississippi and Alabama.
|West End (Cincinnati)||20.1|
|University Circle (Cleveland)||18.6|
How the GOP Budget Undermines Efforts to Reduce It
Here are the recommendations from ODH’s 2009 Infant Mortality Task Force report:
|Recommendation||in plain English||What the GOP did instead|
|Provide comprehensive reproductive health services before, during, and after pregnancy||Fund family planning and coordinate with prenatal||Defunded family planning, defunded prenatal providers who work with Planned Parenthood|
|Eliminate health disparities||Universal health care||Denied insurance to 350,000 Ohioans|
|Prioritize funding based on outcome and cost-effectiveness||Competitive grant process||Instructed ODH to award grants based on politics and ideology|
|Implement health promotion and education for pregnant women||Have women talk to medical professionals as soon as they’re pregnant||Funded CPCs, who lie to women about pregnancy|
|Improve data collection||Use insurance actuaries to centralize data||Kept 350,000 out of the insurance database|
|Expand quality improvement initiatives||Use outcome-based payment system||Rejected ODJFS’s waiver to use outcome-based payments|
|Address the effects of racism on infant mortality||Resuscitating Jim Crow laws certainly doesn’t help||”I don’t want to make blah people’s lives better”|
|Increase public awareness on the effect of preconception health on birth outcomes||Improve access to family planning||Defunds family planning, funds anti-science CPCs|
|Develop, recruit and train a diverse network of culturally competent health professionals statewide||Increase the number and diversity of health care providers||Rejects $13 billion in federal money for health care providers|
|Establish a consortium to implement and monitor the recommendations of the Ohio Infant Mortality Task Force||Don’t forget what we learned in 2009||Completely ignores what we learned in 2009|
How the GOP Budget Is Worse than the Status Quo, in 3 charts
To understand Ohio’s infant mortality, you have to understand Medicaid coverage for pregnant women. The graphs below are from Hamilton County Public Health’s 2009 report.
Medicaid covers 40% of childbirths in Ohio, because it covers uninsured pregnant women up to 200% of poverty. The infant mortality rate among Medicaid-covered births is almost 2.5 times that of privately-insured births.
The likely reason for that infant mortality is higher in Medicaid is that privately insured women are able to access prenatal care immediately. Uninsured women 1) get pregnant, 2) realize they’re pregnant, and 3) enroll in Medicaid. This can take up to 4 months.
In the meantime, women can pay out-of-pocket for prenatal care and seek reimbursement from Medicaid retroactively. On top of the false denials for retro coverage, women have to find a prenatal provider who takes cash and they need disposable income to pay for prenatal upfront. As a result, many women simply don’t get prenatal care prior to enrollment.
Sure enough, Medicaid-enrolled women are 3.5 times more likely to receive inadequate prenatal care.
The last element is the mortality by prenatal care–and this is the real shocker.
Inadequate prenatal care results in more infant deaths than does high-risk birth.
Even though high-risk pregnancies are more likely to result in preterm birth, it’s more fatal to delay prenatal care.
And the House GOP just put on a clinic in delaying access to prenatal care.
By denying the Medicaid expansion, women will still be uninsured when they get pregnant. To enroll, women have to send 1) proof of income, 2) proof of citizenship, and 3) proof of pregnancy. As I said earlier, this can take 4 months–putting women in the second trimester.
Defunding Planned Parenthood means women will have to pay cash for proof of pregnancy. “Proof of pregnancy” is a medically-administered positive pregnancy test. Anecdotally, this is usually done at a Planned Parenthood or other family planning health center. Crisis Pregnancy Centers are not medical facilities; while they’ll offer free pregnancy tests, women won’t be able to enroll in Medicaid based on those tests.
Funding CPCs means women will run a gauntlet of disinformation prior to getting prenatal counseling. CPCs are engineered to coerce women out of having abortions. To achieve that goal, they lie about biological facts of pregnancy. While women will eventually get prenatal care from an actual doctor, they’ll have to counteract the brainwashing they received at the taxpayer’s expense.
Rejecting federal assistance will prevent new perinatal centers from opening. Obamacare sets up no-copay coverage for family planning, prenatal, neonate, and postpartum, with guaranteed maternity coverage. This is compared to the status quo, where 40% of deliveries only have guaranteed prenatal.
Republicans are so obsessed with attacking Ohio’s women that they will actively and knowingly take strides to increase infant mortality in the process. The Senate needs to fix these provisions and send a sensible budget along–or else the governor needs to veto the budget.
Otherwise, John Kasich will be held accountable for Ohio’s abysmal and depressing infant mortality rate.