Niki Kelly, writing for the Fort Wayne Journal Gazette, reports that Indiana’s Medicaid program will no longer pay for early elective births. The rationale is that babies born early or small are at higher risk during their first year.
The Family and Social Services Administration – which oversees the low-income health program – said about 15 births a month might be affected.
Early elective births prior to 39 weeks’ gestation, such as planned inductions or C-sections, can still occur if the birth is eligible under a list of approved medical indications or occurs naturally.
Seems like I’m missing something in translation. Medically necessary early births are still covered. Seems odd that women would be choosing early elective births that were medically unnecessary. Maybe there is a grey zone where the mothers feel the early birth is necessary but Medicaid isn’t going to pay? In any event, the statement by the Medicaid Director seems to have an element of chest puffing that looks out of place in a purely medical discussion:
“This action sends a strong and clear message that we will not tolerate dangerous and unnecessary early childbirths, which puts our newborns at risk and increases costs in Medicaid,” said Joe Moser, Indiana Medicaid Director.
Maybe it’s an abortion thing?
I know that both patients and doctors will schedule induction or C-sections early due to scheduling conflicts. I know one mom that scheduled early because her preferred doctor was going on vacation during her due date.
Doctor buddy of mine mentioned elsewhere that it often happened when there was a combination of mom tired being pregnant and doctor going on vacation.
When I was a managed care counsel for an multi-state health plan we observed this pattern. A lot of C-sections being done because of scheduling conflicts or lack of covering docs. As I recall, the medical director of the health plan worked with some of the ob-gyns to obtain better covering services and it reduced the amount of C-sections appreciably.
What disgusts me is the practice of inducing labor to get the deductible benefit of having a child in the current tax year.
Doesn’t seem to be an “abortion thing”. The definition of “early elective birth’ is at 36-38 weeks (39+ weeks would be a “normal” birth) at which point an abortion way out of the picture. Rather it appears to me — chest puffing or not — that the denial of payment is a sensible arrangement. While births can occur in pre-39-week period they are demonstrably less safe for the baby. There is a higher risk of various complications for early-birthers. Additionally more of the babies go to the, expensive, neo-natal care facilities. So it makes sense, both from a financial and overall heath standpoint, for the public to not pay for early elective births.
If I can believe statistics from ‘leapfroggroup.org’ Indiana had an — incredible to me — 27.7% (2010); 16.7% (2013) of its births as “early elective deliveries”. My personal feeling is that this should be 0.00%. Nature meant humans to carry babies for the full term. Why by-pass this just for convenience? But then my bias is that I am not female nor, obviously, pregnant. I’ve merely had to “suffer” with my wife carrying our kids full-term.
My “abortion thing” question was directly aimed at the chest puffing. I mean, you wouldn’t have a government official saying, for example, “This action sends a strong and clear message that we will not tolerate Hoosiers taking less effective cholesterol medicine!”
So, I was wondering if the firey rhetoric was borne of a perceived response to some bizarre epidemic of self-centered women who just can’t be bothered to wait a few more days.
Sounds to me more like it was targeted at the doctors who schedule these.
I don’t see how an *elective* early delivery is compatible with “First, do no harm”.
“Do no harm” requires the physician to let the child be born normally. That might happen in a taxi or an airport. Where’s the timeshare in that?
There is new-ish language that has changed the definition of a “term birth” from 38-41 weeks to 39-42 weeks. This change is beneficial for both moms and babies, though it is very hard to get past the embedded belief that 38 weeks is full term. As such, many moms, tired of pregnancy, would come to their OBs and ask for induction at 38 weeks. Since it was considered full-term, there was no general reason to deny the induction. There has always been reasons to deny non-medically emergent inductions, but this has been difficult to enforce.
The most shocking statement in this story: “About half of all births in Indiana are covered by Medicaid.”
Why is that shocking? There are no jobs or opportunities in this oligarcharchial, Third World-esque state.
Seriously, Gary, take a drive to Randolph County or Scott County or Vermallion County, or, heck Anderson, and tell me a substantial part of those people aren’t living in a ghetto as bleak at any inner city one.
no hope, no future, bad schools (my niece knew three OTHER girls in her JUNIOR high who were pregnant) = social dysfunction.
Did you read the articles I posted here describing how titanic regulation has brought entrepreneurship and individual economic activity to a halt?
Well, since Indiana is barely regulated at all and is run by the Chamber and Indiana Manufacturer’s Assoc, can you just pretend I have read your wistful, libertarian paean to grand days of anarchy and Gilded Age neo-feudalism?
Oh, the America of urban tenements and rural sharecroppers….that was a glorious time
“Well, since Indiana is barely regulated at all”
That’s absolute nonsense that ignores the multiple layers of regulation, from federal to county/city, that apply to a business sited in Indiana.
I was put in for my c section 10 days early. They told me they didn’t want me pregnant any longer and that the baby was measuring small. First they told me that my baby had a breathing episode and I asked them after all they kept saying , I asked them if there was any major problems, they kept telling me no. They had me so upset and thinking it was an emergency c section cause they said they needed to get her out, when I went to the er to register and told them I was there for an emergency c section the hospital said no it’s not an emergency c section. But then they took me directly back and prepped me for surgery. I was 38 weeks and they said i was measuring at 35 weeks. I am only 4 foot 9 inches and weighed 127 lbs. I am a small woman and I think maybe they should have waited a week or two longer, my baby was born at 6 lbs 5 oz and was 19 and a quarter inches long. Over the first week she was alive she done nothing but drop weight, could be a possibility of things but she got down to 5 lbs 9 ozs and had to have a return stay at the hospital of 2 additional days. I wasn’t the only one from this Obgyn office that was sent in way early there was another girl who’s labor was induced 11 days early and was told the same exact things as me that she was measuring small and they didn’t want her pregnant any longer