Pregnancy is both an exciting and scary time. One thing moms do not need to be wasting their time worrying over is how they are going to pay for the arrival of their little bundle of joy. For many women with less than amazing health insurance plans, and for those with no insurance, the impending hospital bills alone are enough to keep them up all night! But for low-income women and their families, there is another option. Medicaid! That’s right, this government program exists to help the poorest in America get the healthcare they need, at little to no cost.
With all the information out there on the internet, and all the noise coming from cranky politicians, it can be difficult to separate fact from fiction. It may even feel like the facts are being kept secret deliberately! Well, we are here to help sort through the tangle of information, and misinformation, about Medicaid. It may be that some mommas out there don’t know all there is to know about requirements and eligibility. Or maybe there are questions about coverage, options, and the controversy that so often surrounds this topic. Below you’ll find 15 “secrets” that Medicaid is keeping from pregnant women.
15 It’s Not Medicare
Many people often confuse Medicare and Medicaid, and it’s easy to see why! They have very similar names, were created only a decade apart, and are often mentioned together in the media. Medicare is a program that began in 1956. The program was originally part of the Dependents’ Medical Care Act, an act which was designed to provide medical care for military members and their families. In 1965, President Johnson signed a bill allowing Medicare to be available to all residents at least 65 years old.
Medicaid, though created in 1965 as part of the Social Security Amendments of 1965 which also spawned the version of Medicare we know today, is a separate program that focuses on providing healthcare for those with low incomes. Medicaid is a program that states must opt into, and as such the program can vary substantially from state to state. In general, it provides coverage for low-income adults, children, and the disabled.
14 Where The Funding Comes From
It’s no secret, if you live in the United States, that Medicaid is seen by some as a controversial program. Often, this controversy surrounds the funding of the program. Medicaid is a program that is run by both the federal and state governments. This means that states are free to set their own rules, as long as those rules at least meet the minimum federal guidelines. The joint nature of the program also means that Medicaid gets its funding from two sources.
Medicaid is funded by both the federal and state governments. This means that the funding levels can vary drastically from state to state, depending on how much money each state decides to give the program. According to The Henry J. Kaiser Family Foundation, the federal government matches each dollar that states spend on their Medicaid programs. The states themselves are free to choose how they generate revenue for the program.
13 Medicaid Was Expanded In Many States Under The Affordable Care Act
When the Affordable Care Act was passed in 2010 it made a lot of changes to the way healthcare works in the United States. Pre-existing conditions were no longer an excuse for insurance companies to deny coverage, contraception had to be covered at no cost, and states were given the option to further expand their Medicaid programs. Many states have since done so, though equally, many states have also opted out. This means that a person may not qualify for Medicaid in the state they live in, but that same person would meet the requirements if they loved in a different state. Sounds confusing, right?
Put another way, in many of the states that opted to expand their Medicaid programs there are now more citizens eligible for the program than there were before the expansion. This is great news for moms and their babies! However, in the states where lawmakers opted out of expanding the program, there are fewer people who are eligible to apply for Medicaid. So, it’s important to check the requirements of your individual state before assuming you don’t qualify!
12 Coverage Varies From State To State
As we have mentioned before, Medicaid is run as a joint state and federal program. States are free to tailor the program to the needs of their population, provided they meet federal guidelines. This has created some controversy. It is, in fact, just one of many sources of controversy for the program. A person only needs to glance at a map of which states decided to expand Medicaid to see that there are huge gaps in the country.
Specifically, states in the Midwest and the South were among the least likely to expand their programs on a state level. This leaves a good number of Americans without access to healthcare services through Medicaid. And as we know, access to healthcare services, that won’t break the bank, is very important for continued productivity and increased the well-being of the individual. And of course, through this program hospitals get at least a portion of their bills paid, which may not happen if an uninsured patient walks in the door! It’s a win-win for everyone!
A person may be eligible for Medicaid for several reasons including being pregnant, a child, a parent, a senior citizen, or disabled. Guidelines for Medicaid eligibility are established by the federal government. Eligibility is based on where a person or household falls in relation to the federal poverty level. With the inclusion of the ACA, states were given the option to raise the income limit for eligibility, which in many states resulted in more people becoming eligible for the program.
For many people, Medicaid makes it possible for them to see a doctor. This is especially important for pregnant women, who face a whole host of different health issues than non-pregnant women. Additionally, studies have shown that receiving adequate medical care while pregnant helps increase the chances for a healthy and safe birth! Those with questions about their Medicaid eligibility should visit the official Medicaid website.
10 Number Of Enrollees
As is to be expected the number of enrollees in the program fluctuates a fair bit depending on what’s happening in the country at the time. When the economy is not doing too well and people are losing jobs, more people sign up for the program. But when things are looking up for everyone, enrollment tends to take a dip. The most recent statistics available for 2017 indicate that there are currently 68.4 million people enrolled in the program, that’s nearly 1 in 5 Americans!
A number that high, of course, includes all enrollees. So, all the low-income adults, children, and people with disabilities who have signed up for the program. With that many people relying on Medicaid for access to healthcare, it certainly seems like a very important program! In addition to the 68.4 million people enrolled in Medicaid, as of July 2017, there are further 5.8 million children enrolled in CHIP (Children’s Health Insurance Program).
9 Number Of Pregnancies Paid For By The Program
Many people think of Medicaid as a program that only a few of the poorest in the nation need to rely on. It might be a surprise to learn that Medicaid paid for 48% of all births in the United States in 2010. And in many states, Medicaid now pays for over half of all births. That’s a lot of babies!
That Medicaid covers births is a point of contention for many. Those opposed tend to argue that women make the choice to become pregnant and therefore taxpayers should not be responsible for footing the bill. On the other hand, proponents argue that healthy moms and babies are in everyone’s best interest, not to mention that women do not always choose when to become pregnant. No matter which side of the argument a person falls on, we’re sure glad Medicaid is here to take care of moms and their babies.
8 Prenatal Coverage
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Any woman who has been pregnant can tell you, it gets very expensive! There’s loads of stuff you have to buy. From baby things, including clothes and toys, to larger purchases like cribs and strollers. And let’s not forget that mom will need a new wardrobe to accommodate her changing figure! Towards the end of a pregnancy, you are practically living at the doctor’s office, and all those office visits can really add up! Thankfully for the women who use Medicaid, many of their prenatal needs are covered.
Covered services include prenatal doctor appointments, routine lab tests, and even midwife services. Women who have a more high-risk pregnancy are also covered, which is great news considering the additional tests high-risk pregnancies can involve. Moms-to-be shouldn’t let the fear of medical bills keep them from seeking proper care during pregnancy. This is especially true given that interventions and routine medical visits early in a pregnancy can help lower the risk of complications!
7 Delivery Coverage
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It seems unnecessary to point out, but we’re going to anyway, that Medicaid also provides coverage for the actual birth of a child. This part can get pretty expensive, especially if medical interventions are necessary, or mom chooses to receive an epidural as pain management. And the last thing mom wants to be thinking about as she’s trying to bring a new life into the world is how much it is going to cost her. Thankfully most aspects of a birth are covered!
It does not matter if mom has a normal, low-intervention, vaginal birth or needs to be induced, it’s all covered! Even caesarian sections, which are far more expensive than vaginal births, are covered whether they are scheduled or not. This should be a great relief to all moms who rely on Medicaid for their medical coverage. No need to worry about how you’re going to pay the ginormous bill when you leave the hospital!
6 Coverage For Birthing Centers
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While most women in the United States choose to have their babies in a hospital, there is another option. In fact, in some other countries healthy women with low-risk pregnancies are encouraged not to give birth in a hospital and instead to choose a birth center or a home birth. Birth centers pride themselves on offering, “a more natural, family-centered childbirth experience without routine interventions.” If that sounds like your bag, and you are enrolled in Medicaid, you’re in luck!
Medicaid provides coverage for women who choose to give birth in a licensed birth center. Staffed by licensed midwives, birth centers can be a great alternative to the institutionalized feel of a hospital. Of course, not everyone will have easy access to a birthing center. For example, there may not be one within a reasonable driving distance. Or perhaps mom just feels more comfortable with a doctor, giving birth at a hospital. Either way, you do you!
5 Postnatal Coverage
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The coverage doesn’t stop there, which is good because mom is just getting started! Medicaid also helps by covering the costs of many postnatal necessities. These include doctor’s office visits for both mom and baby and contraception coverage, both of which are super important for mom’s health, not to mention the healthy start all infants get by visiting a pediatrician during those first few months. So, there is no need to stress about money when the little one wakes up sick in the middle of the night!
Contraception coverage is particularly important as it helps mom spread her pregnancies out safely, giving her body and mind time to heal between each baby. Studies have shown that spacing pregnancies out, and access to healthcare in the months following baby’s arrival helps mom immeasurably when it comes to physical healing and mental stability. Additionally, with the rising public awareness of postpartum depression, it’s even more important for mom to have easy access to care after she gives birth. Healthy moms and babies are good for everyone!
4 Car Seat Coverage?!
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Yes. That’s right. In some cases, it is even possible that Medicaid will help pay for a car seat for that new bouncing bundle of joy! And that’s really awesome for a couple of reasons. First, new parents have to buy so many things for the baby. And while not all of them are necessities by any means, a new car seat is insanely important.
Secondly, there’s any number of reasons why baby might need a new car seat. Did you know that car seats have expiration dates? They do! Or what about that there’s no real way to tell if a used car seat is safe? Or maybe baby outgrows his infant car seat with such incredible speed that mom and dad are suddenly faced with the prospect of buying a new one? Having a new and properly installed car seat is important for every family with small children. Car seats really do save lives, so helping families afford them is beneficial for everyone.
3 Americans Largely Support Medicaid
It might be difficult to tell, but the majority of Americans actually look favorably upon the program. Many politicians, particularly on the conservative side, like to go on and on about entitlements and how they are ruining America. Making Americans soft, setting up an expectation of deserving things rather than earning them. But as it turns out most Americans support a program that helps diminish our maternal mortality rate, who knew!
According to a poll conducted by the Henry J. Kaiser Family Foundation, “The majority of the public – regardless of partisanship – hold favorable views of Medicaid.” In fact, 74 percent of those surveyed said they have a favorable view of the program. Whereas only about one-third of respondents support cutting funding for the program. This is great news for the millions and millions of Americans who would not be able to see a doctor without this program.
2 You Might Not Get To Keep Your Doctor But…
It’s true, not every healthcare provider accepts Medicaid. It’s possible that a person will qualify for the program and then not be able to find a doctor near enough to them, who is also accepting new patients. We imagine this is even more likely in those states that did not expand their Medicaid programs. But there is good news too!
According to Slate, “[i]t is true that many doctors do not accept new Medicaid patients, in large part because the program pays physicians relatively little for their services.” And that’s certainly a major issue. But! It also, “appears that more doctors have started to see Medicaid enrollees in the years since the program expanded under the Affordable Care Act.” So, yes, a person may not be able to keep their doctor, they will certainly have more choices than they did in the past.
1 Using Medicaid Is Better Than Not Having Insurance
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This may seem obvious, but it is important to point out that having insurance is way better than not having insurance. There’s a stigma surrounding Medicaid in the United States, that people who rely on this program are somehow less than. Perhaps they went wrong somewhere in life. Or perhaps they just don’t work hard enough. This could not be further from the truth!
This program exists to help people who need help! It should be used for that purpose! A study conducted in Oregon in 2008 showed that women who utilized Medicaid were 60% more likely to get a mammogram! Across the board, people were more likely to go to the doctor’s office and get the care they needed than people without insurance. Surely improvements like this are something we can all get behind!