Pregnant Women, Child Health, and Proven Prevention Programs- Why the Struggle During the 2010 Legislative Session?

Maternal and child health care advocates, providers, and families struggled for months to save the network of proven health, prevention and early intervention programs throughout the long and labor intense 2010 Legislative Session. 

Thanks to the heroic advocacy efforts of many organizations and individuals, some key programs were saved, some support programs suffered, and then some like the KidCare program never had a chance to be heard.

Why cuts to health care for pregnant women and children and  valuable early support and prevention programs that result in healthy children ready to learn and succeed in school?
The dynamics of a severe Florida budget deficit, political party conflicts, and a major election year in November 2010 all played into the turmoil a challenging Florida Legislative Session.  To make matters worse there was a war waged by many Republican leaders to secede from the national health care reform bill, and Attorney General Bill McCollum, led the charge for other states by filing a lawsuit, intended to nullify the national health reform. 

Good news…..The vital health care services of Healthy Start Coalitions, were fortunately saved from the initial devastating proposals to eliminate the Coalitions and shift service dollars. In the attempt to save $4 million it would have eliminated the $ 32 million in additional funds leveraged by the individual Coalitions statewide.  Considering the near collapse of a vital and quality program, the final loss of $ 2 million in service dollars should be easier to deal with this year. Another budget win was the failure of the final budget to include a reduction in the federal poverty level, FPL, for pregnant women from the current 185% of FPL to 150% FPL. 

Saved again this year was funding for the Part C early Steps program to effectively serve children with developmental delays and prevent the deep ended costs for their future care.

Fortunately for children and low income pregnant women, the House and the Senate could not agree on the expansion and revision of the Medicaid program.  All children and pregnant women covered by Medicaid would have been moved into private managed care organizations. Children represent 53% of the Medicaid population yet cost only 19% of the dollars, little saving gained.   Pregnant women, according to research by an independent agency, indicated that pregnant women have not fared well in the managed care Florida reform pilot program.

Sadly Healthy Families Florida, a proven prevention program that has successfully reduced child abuse and neglect by 98% in high risk areas of the state, was cut by $ 9.9 million this year. Many of the Healthy Start coalitions with high risk mothers have worked closely to provide the supportive nurturing services to young women.

The KidCare bills were lost in action among the many battles for maternal, child health, and child welfare issues.   The proposed bills would have improved and increased enrollment provided a structure for the continuity of care, and access to millions more additional federal funds for the KidCare program.
Administrative and simplification policies to improve KidCare may not require legislation and those efforts can continue until the 2011 session.

As national health care reform moves forward hundreds of thousands of uninsured children in Florida who are not eligible for KidCare are expected to get coverage under the national Exchanges.  The immediate victory that prevents discrimination against children with pre existing conditions by denying them coverage will soon begin. What a major step for children and relief for families coping with financial hardships.