Prenatal Care Coverage for All Women Briefing

The Problem:
Under Virginia’s FAMIS Moms program, pregnant women at or below 150% of the federal poverty level qualify for full prenatal care. However, all children in Virginia are covered through FAMIS up to 200% of the poverty level. This gap in coverage for pregnant women above 150% means many babies do not receive adequate heath care until after they are born. In Richmond in 2002, for example, over 35% of live births were to women receiving inadequate or only intermediate (late) prenatal care.

Background:
Adequate prenatal care includes: monthly visits during the first two trimesters (from week 1-28), biweekly from 28 to week 36 of pregnancy, and weekly visits after week 36 (delivery at week 38-40). The goal of good prenatal care is to detect and prevent any potential complications and to direct the woman to appropriate specialists, hospitals, etc if necessary. The availability of routine prenatal care has played a part in reducing maternal death rates and miscarriages, as well as birth defects, low birth weight, and other preventable problems.

Prenatal care is especially crucial for women at increased medical and/or social risk, such as those from low income households, those with less than a high school education, those who become pregnant as teenagers, and those with a large number of children. However, studies show that communities in rural areas as well as minorities are less likely to have available prenatal care, have higher infant mortality rates, and higher rates of involuntary termination of pregnancy.

The Solution:
The Virginia Interfaith Center supports a budget amendment bill that would make an additional $4.5 million available to the FAMIS Moms programs to expand prenatal care coverage to all pregnant women at or below 200% of the federal poverty line. This level of coverage would bring these women up to the medical coverage received by their babies after they are born.

Prenatal care is extremely cost effective:
- A woman who does not receive prenatal care is three times more likely to deliver a low birth weight baby whose chances of health complications and learning disabilities is much greater than a normal birth weight baby.
- Hospital charges for severe premature/low-birth weight babies are 60 times more than an uncomplicated birth.

Forty states have higher eligibility levels, in recognition of the cost-effectiveness of prenatal care.

By expanding coverage, Virginia would avoid indigent care costs as well as the enormous costs associated with poor birth outcomes from lack of appropriate prenatal care. 

Last year, Governor Warner’s proposed budget allowed for prenatal coverage for women up to 185% of the poverty level, but the extra funding was cut later by the House.

Additional Background:
The FAMIS Moms program sets eligibility for pregnant women at 150% of poverty. ($2,075 / month for a family of three).

Thirty-seven states have higher eligibility levels.

Because women who receive prenatal care generally have better birth outcomes, prenatal care is extremely cost effective.

A woman who does not receive prenatal care is more likely to deliver a low birthweight baby.

The lack of prenatal care is associated with a 40% increase in the risk of early infant death – even for babies born at full term.

Hospital charges for severe premature/low birth weight babies are sixty times more than an uncomplicated birth.

By expanding coverage, Virginia could
ensure that all the mothers of FAMIS-eligible babies have access to prenatal care;
avoid state-funded indigent care costs;
avoid the enormous short and long term costs associated with low birth-weight infants.

Expanding eligibility to 200% of poverty would help more than 1,000 low income pregnant women in Virginia access prenatal care.

The general fund cost of about $4 million/ year would be matched by about $8 million in federal funding. This is a great investment for Virginia!

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