Blogger's Note: A version of this article appeared in the Albuquerque Journal Jan. 30, 2013
In the aftermath of Sunday’s front-page article in the Albuquerque Journal on how 70% of births in New Mexico are financed by Medicaid, we are beginning to hear the conservative refrain. The “takers” are at it again, they say. So many people on “welfare,” so many children hooked on government from birth. Its like Captain Renault (Claude Reins) telling Humphrey Bogart in Casa Blanca, “Shocked, I’m shocked that gambling is going on in this establishment. “ Of course, as the Captain is speaking, he is handed a note from a croupier that tallies his winnings.
In New Mexico the “winnings” are the payments for the births that go to the hospitals the delivery room nurses, the doctors, to small and large towns throughout the state who, would be struggling to collect from low-income parents, or paying for the deliveries themselves, were it not for the program.
The winnings are also in the health of New Mexico’s children, about 2/3 of whom are born into families who need a little help. For about two decades, the state has seen it as a good investment here in one of the poorest states of the country, especially when the federal government is paying the lion’s share. Even considering the cost of deliveries, the price tag for prenatal care, childbirth and health coverage for children is relatively modest, in comparison to other program expenses like nursing homes. Without this initial investment the costs to the state in premature births, poor outcomes, special education, even criminal justice, would be much more.
This summer, the Legislative Interim Health and Human Services Committee heard about another program that, for young children, could increase the return on the investment even more. It’s called home visiting. It’s a voluntary program that is already yielding results for young families in Rio Arriba and Grant Counties as nurses and community health workers visit with first time mothers throughout their pregnancy and during those first crucial months after the birth of their babies. The trained health care professionals teach parenting skills and assist mothers with routine care, making sure that the baby has all its shots, and that problems don’t turn into domestic crises. But of the approximately 19,000 newborns on Medicaid each year only about 1100 get the service through a program in the Children Youth and Families Department, which for the most part is funded through private foundations. At present, there is little state Medicaid funding—with its attendant federal match--and the state is missing a huge opportunity to get more women pre-natal care, increase the number of well child visits, and save money in the long run.
The staff of the Legislative Finance Committee estimates the return on investment for home visiting is five dollars for every one invested. This year’s LFC budget recommends increasing Medicaid funding for home visiting so that 500 more families get this important service. Sen. Jerry Ortiz y Pino is carrying Senate Bill 68 to boost the CYFD programs. These are modest proposals that deserve your support —particularly if you are shocked, shocked by the number of Medicaid births. This investment may bring them down in the long run, one family at a time, as new parents begin to understand the responsibility of parenthood, gain self-respect and think again about that second or third child. Combine that with a decent rate of economic growth and you’ve got a big payoff for New Mexico.