Making Medicaid a block grant will endanger Alaskans

The majority of families who rely on Medicaid for insurance coverage are working. They are your neighbors, friends and co-workers. In my area of practice — women’s health and birth care — having Medicaid coverage can make the difference between a healthy pregnancy and one that becomes high-risk because the mother lacked access to early interventions, and can make the difference between a thyroid or breast cancer discovered early enough to treat, or one that takes a woman’s life.

I am a small-business owner, mother, grandmother and certified nurse midwife, and I have assisted thousands of families through pregnancy and birth and have provided primary care during my 27 years here in Anchorage. It was a huge relief for health care providers when Medicaid was expanded in 2016 to provide healthcare access to more families. We credit access to health insurance as an important factor in our low cesarean section rates and great outcomes. Without coverage, pregnant women often delay or limited their care due to costs, but with coverage, they are able to start prenatal care in the first trimester and we can identify problems early and prevent complications. With coverage, women of all ages can get the regular screenings they need to identify problems such as cancer before it’s too late.

I understand our governor is requesting that our Medicaid program be turned into a block grant program. This would decrease the amount available to spend on mothers, children and families. This makes no sense unless the purpose is to hurt low-income families.

In our birth center we treat everyone equally, regardless of their payment method. Reimbursement from Medicaid is currently one-third what the reimbursement is from Blue Cross for pregnancy, but we serve Medicaid patients the same. The governor is talking about lowering the reimbursement rate to providers and hospitals as a way to save money. What will happen instead is more providers will decide they can’t afford to take Medicaid clients. Is the purpose, once again, to hurt low-income families?

When you think about it, there really are few health care interventions more important than seeing a pregnancy to its (full term) completion with a healthy mom and baby. Dollars spent in prenatal care and preventative health care are dollars saved when the baby is not preterm and in the newborn intensive care unit. Taxpayer money is saved when women get nutritional counseling and smoking cessation counseling. And when women use the knowledge they attain during prenatal visits, they are more likely to grow a healthy baby unaffected by drugs or tobacco.

I believe in the inherent goodness of people. I know that everyone cares about mothers and babies. Providing for mothers during pregnancy and children once born is our moral obligation and responsibility, and we do this gladly. Cutting the programs that help families live healthy lives makes no sense. Cutting Medicaid reimbursement will mean that there are fewer providers willing to provide this care. Turning Medicaid into a block grant will mean there will be people left without care at all – with emergency rooms and NICUs picking up the bill as problems are left untreated.

I have been blessed to be able to do this sacred work for 27 years in Alaska. Won’t you join me in telling Gov. Mike Dunleavy and the Legislature that we want to protect health care for our Alaskan families, and that we expect an operating budget that fully funds Medicaid?

Barbara Norton, CNM, APRN, has been a women’s health care Nurse Practitioner since 1985, a midwife since 1994 practicing in the hospital, and a birth center midwife since 1997. She currently works at Geneva Woods Birth Center in Anchorage.

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