A group of lawmakers tried in 2010 to create a federally sanctioned program that would have qualified fetuses for coverage, but the effort failed under the weight of anti-illegal immigration sentiment and election-year anxiety.
Some health care institutions, including a practice at the University of Nebraska Medical Center, have helped fill the void by providing free or discounted prenatal services to women who lost coverage. It's unclear how many benefited.
Health care providers that serve pregnant women say the loss of coverage has endangered women and their pregnancies.
Rebecca Rayman, executive director of the Good Neighbor Community Health Center in Columbus, said the loss of Medicaid coverage has drawn more women to her clinic, which is federally recognized and cannot deny service based on an inability to pay.
She said the cuts have also meant longer drives for women — 150 miles, in some cases — who often lack reliable transportation. The center's average patient load of 139 pregnant women in March 2010 surged last year to 366.
The amount the clinic received in Medicaid reimbursement fell to $333,000 last year, compared with nearly $524,000 in 2009, which forced cuts to dental services and other less-pressing needs. Rayman said four fetuses died after the subsidized care ended.
"The whole immigration argument is puzzling to me," she said. "When I think of the United States, we don't punish the innocent. And a newborn child is innocent. It's not an immigration issue. It's a health care issue."
Abortion is an especially important issue in Nebraska, which has become a national leader in efforts to limit the procedure. In 2010, the state became the first to ban abortions after 20 weeks of gestation based on the disputed notion that a fetus can feel pain at that point.
"That baby, at 20 weeks and one day, is a baby — not a fetus," said Republican Sen. Sen. Bob Krist, of Omaha. "At 20 weeks, that is a future citizen of the United States, and a fellow Nebraskan. If you deny services for the baby or the life support system — the mother — you are harming a future Nebraskan."
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