Bill to create new prenatal program clears first round

Senators advanced a bill from general file April 3 that would establish a program to offer prenatal services to low-income women regardless of immigration status.

Lincoln Sen. Kathy Campbell, sponsor of LB599, said the bill was intended to allow Nebraska to cover the cost of prenatal and pregnancy-related services connected to the health of an unborn child.

Campbell explained that the state was notified two years ago that its means of determining Medicaid eligibility for the families of pregnant women was in violation of federal guidelines. She said the notification from the federal government made it clear, however, that Nebraska could establish a state-based program.

“For well over 20 years the practice in Nebraska has been to cover the cost of prenatal care for the unborn children of low-income women,” she said, and LB599 would re-establish that practice.

Under the bill, the state Department of Health and Human Services would be required to establish a program under the Children’s Health Insurance Program (CHIP) solely for the unborn children of mothers who are ineligible for coverage under Medicaid.

Eligibility for service would be determined using an income budgetary methodology of no greater than 185 percent of the federal poverty guideline.

Benefits would include:
• laboratory testing;
• outpatient hospital care;
• pharmaceuticals and prescription vitamins;
• radiology, ultrasound and other necessary imaging;
• services related to conditions that could complicate the pregnancy; and
• professional fees and hospital costs related to labor and delivery.

The bill would require the department, within 30 days of passage of LB599, to seek federal approval of a state plan amendment or waiver for Nebraska’s program.

Campbell said faith-based groups and nonprofit organizations have stepped up to provide prenatal care for women no longer covered in Nebraska, but responsibility for unborn children belongs with the state.

“All of these people cannot continue to indefinitely assume the responsibility for this cost, nor should they,” she said.

Lincoln Sen. Tony Fulton opposed the bill. Fulton acknowledged that providing prenatal care to needy pregnant women is a societal responsibility, but said society includes churches, fathers and others who could and should fill that role.

“Is the government the only mechanism by which this care can be provided?” he asked.

Ogallala Sen. Ken Schilz also opposed the bill, saying Nebraska taxpayers should not be asked to pay for health care for illegal immigrants seeking a better life for their children.

“There is a cost to all of this and that cost has to be borne by someone,” Schilz said.

Sen. John Harms of Scottsbluff said recent studies indicate that immigrants do not settle in areas because of the generosity of public benefit programs. Instead, he said, they go where the jobs are. Illegal immigrants would not flock to Nebraska if LB599 passes, he said.

“That argument really doesn’t hold together,” Harms said.

Norfolk Sen. Mike Flood also supported the bill, saying that while the proposal represented a tension between pro-life beliefs and concerns about illegal immigration, respect for life should trump other concerns.

“I believe that when you have life and health in the balance, you err on the side of life,” Flood said.

Sen. Brenda Council of Omaha said the issue of a pregnant woman’s immigration status was irrelevant under the bill because only care related to the health and well-being of the unborn child would be covered.

“Help me understand what illegal activity the unborn child in this situation has engaged in,” Council said.

She added that the state would save money in the long run if the bill passes by reducing the incidence of premature births, low-birth weights and other complications resulting from lack of prenatal care for babies who will be American citizens once they are born.

Sen. Beau McCoy of Omaha introduced an amendment that would have replaced the word “fetus” with “unborn child” in all other areas of state statute. He said the amendment would make state law consistent and reinforce Nebraska’s commitment to pro-life values.

Omaha Sen. Burke Harr challenged the amendment, saying it was not germane to LB599.

Legislative rules stipulate that only amendments found to be germane, or relevant, to a bill may be considered during debate. Harr said McCoy’s amendment addressed many areas of law beyond those addressed in LB599.

Harr’s challenge was upheld and the bill advanced to select file on a 30-16 vote.