Republican leaders in Washington can’t afford to squander their best opportunity by pushing through a “repeal and replace” measure that could leave Maine’s moms and newborns behind.

The House-passed proposal to repeal the Affordable Care Act and replace it with the American Health Care Act includes provisions to enact per-capita caps on Medicaid, cut Medicaid funding by billions of dollars and remove protections for people with pre-existing conditions. The House bill as written would decrease federal funding for the entire Medicaid program, which covers over 70 million low-income kids, adults, disabled individuals and the elderly – and those millions include mothers and pregnant women.

The impact here at home in Maine could be devastating. According to the Kaiser Family Foundation, 43 percent of births in Maine in 2015 were covered by Medicaid. That means almost half our pregnant moms rely on Medicaid funding to ensure they’re receiving adequate prenatal care.

We know firsthand the critical role Medicaid plays in funding care for newborns and mothers. I began my medical career as a physician assistant working in a neonatal intensive care unit participating in the care of the most vulnerable premature infants. It was during that time that I met my future husband, a maternal-fetal medicine specialist, while he delivered a child born at 32 weeks after an extra-uterine pregnancy, a rare condition in which a fertilized egg develops outside the uterus.

He saved the life of the mother, a walk-in patient who had had no prenatal care, while I resuscitated the small neonate. Weeks later, that newborn passed away from multiple complications. The mother survived, but not without her own share of surgical problems.

Both were innocent victims of medical problems that they had no control over – not all that different from what we see today in the rural state of Maine.

Later, we were offered an opportunity at Maine Medical Center to start the Division of Maternal-Fetal Medicine, with diagnostic ultrasound, genetic testing and care of the high-risk pregnant woman. We quickly realized the need to develop a comprehensive perinatal outreach network with Maine’s hospitals, many of which were small, rural community facilities, so that people could receive care without having to travel long distances.

I was honored to serve as director of the Maine Center for Disease Control and Prevention from 2011 to 2015, seeing firsthand the many health care challenges that face our state, especially for our most vulnerable populations, including mothers and infants as well as the disabled and elderly.

Advances in medicine have greatly increased safety for women in delivery, but these innovations are effective only if our residents can access them. Maintaining access to prenatal care for mothers is crucial and could be at risk if the Senate moves forward with aggressive cuts to Medicaid and changes that make funding available based on population instead of need.

There’s no denying that the repeal and replacement/reform of the ACA must be done in a budget-conscious manner, but restructuring our Medicaid program and removing protections for those with pre-existing conditions is not the right approach: It will only transfer the budget issues to Maine’s balance sheet and diminish access to care for those that need it the most. As we move past the mistakes of the ACA, we must ensure our children don’t end up paying the price for rushing the process. Infants have no choice in the health care debate, but we do.

It’s not just infants and children – over 260,000 Maine residents and their families depend on Medicaid for the care they need. This is an issue of public health that ultimately affects everyone. The state of Maine has worked hard to encourage individuals who are able to get back to work and to learn new skills and become self-sufficient so that they, too, can lead independent lives.

Thankfully, we have elected leaders representing us and the needs of our state in Washington who understand this. Sen. Susan Collins has been a tireless advocate for those who need it the most and is dedicated to finding a solution that provides Americans with more health care coverage than the current system, not less.

I hope her colleagues in the Senate follow her lead as the debate continues, ask the tough questions and take the time to get it right, while they work together to revise the American Health Care Act and build a better health care bill that won’t leave moms and newborns behind. Maine needs to continue to take the lead on this issue, while working together for a brighter, healthier future for all.

 

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