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State expands prenatal care program

Veronica Whitney

Rivas is among 400 low-income women in Eagle County helped by Medicaid programs that will soon expand coverage.

Colorado has become the third state in the nation to qualify for a program that will expand coverage and provide prenatal care for low-income women who are pregnant.

“It’s good news to know this has been approved,” says Kathleen Forinash, director of Eagle County Health and Human Services. “That’s the big difference, because more families will be eligible.”



Under the waiver, Colorado expects to add nearly 13,000 pregnant women whose family incomes are at or less than 185 percent of the federal poverty limit, which is $16,391 for an individual and $22,089 for a couple.

The income level to qualify had been 133 percent of the poverty level, or $15,876 for one person.



That means that for a family of two, the monthly gross income to qualify has been stretched from $841 to $1,323, Forinash said.

“This program recognizes the important value of investing in prenatal care,” Forinash says. “It saves dollars down the road because, when you have good prenatal care, kids are born more healthy.”

Every dollar spent on prenatal care can save $3.38 by reducing the number of newborns in intensive care, says Dr. Dan Hall, medical director of The Children’s Hospital Newborn Center in Denver.



The program grants a special waiver to provide prenatal care for low-income women under the administration’s Health Insurance Flexibility and Accountability Initiative, or HIFA. Colorado will use a comprehensive benefit package designed to be similar to health insurance. The state will use unspent State Children’s Health Insurance Program, or SCHIP, funds to finance the program. To date, six states, including Colorado, have used HIFA waivers to expand access to health care coverage to people without health insurance.

“”Too many women in Colorado cannot afford insurance to pay for critically needed medical care during their pregnancy,” says Gov. Bill Owns. “This program will help address this problem and improve the health of thousands of Colorado women and their children.”

In May, lawmakers expanded the state’s health insurance plan for low-income children, known as the Child Health Plan Plus.

At the time, the program provided health coverage to low-income infants and children, but not to their mothers if they were 19 years of age and older.

“At any given time we (Eagle County) have probably 230 families on our regular Medicaid rolls who are receiving prenatal care and care after the baby is born,” Forinash says.

The program covers up to $7,500 of prenatal and $450 of delivery costs.

The county also offers an emergency Medicaid program – funded by a grant from the state Department of Health, helping about 150 pregnant women a year.

“It’s for women who aren’t eligible for regular Medicaid because there aren’t residents of the country,” Forinash says.

Only documented residents of the United States qualify for regular Medicaid.

“One of the concerns is that capacity will bring more work,” she says.

The Eagle Care Clinic in Edwards will serve approximately 350 pregnant women in 2002, says Debra Swain of Vail Valley Medical Center.

“Our Eagle Care Clinic does not have infinite capacity,” Swain says. “With increasing patients and without corresponding increases in staff and financial resources, as well as space, it could become difficult to meet the needs of a quickly growing patient population.”

Approximately 40 percent of the clinic’s patients have regular Medicaid, which covers prenatal care and delivery, Swain says. About 75 percent of the remaining patients qualify for emergency Medicaid, which covers only the delivery of the baby, as well as any extreme life-or-death emergencies that the mother might face during the course of her prenatal care. Emergency Medicaid does not cover the cost of prenatal care.

“Women who have emergency Medicaid most often have their prenatal care covered by the Colorado Prenatal Program, which is not part of Medicaid,” Swain says.

Forinash says she’s still waiting for information on when the new program will be effective. To apply, pregnant women have to contact Eagle County Health and Human services.

Veronica Whitney can be reached at 949-0555, ext. 454, or at vwhitney@vaildaily.com.


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