It seems that Utah, despite its claim to “think of the children” and to put “family first,” it rarely manages to do so when the rubber meets the road – particularly when it comes to providing services designed to help low-income families and those who are struggling to get by. This “pick yourself up by the bootstraps” mentality can work when you have access to the resources necessary, but falls flat when people don’t have access to basic needs such as mental and physical health care.
And that, perhaps, is why HB 122 – Medicaid Waiver for Postpartum Mental Health Coverage from Representative Ed Redd (Republican – Logan) is a small, but important, piece of legislation.
Though the mission of this legislation to help prevent postpartum depression for women in poverty is a good and right mission, it represents a disturbing trend in state and federal health care policy that we as a state and nation should take a long, hard look at.
HB 122 looks to help alleviate postpartum mental health issues for those most vulnerable in Utah, namely those who exist in the so-called Medicaid “donut hole” – a hole created by the tragic failure to expand Medicaid to some 190,000 men and women who make too much to receive Medicaid benefits, but too little to be considered outside of poverty, and therefore unable to take advantage of the health insurance exchange.
The bill will petition the United States Department of Health and Human Services to grant waivers to allow Medicaid to cover postpartum mental health services for those who happen to fall into this gap. Though no fiscal note was attached to the bill at the time of publication, a memo from the Utah Department of Health estimates that some 8,300 mothers are expected to enroll in such a service if it were to become available.
Though the mission of this legislation is a good and right mission, it is marking an increasing trend in the legislature of creating a patchwork of health care coverage for those who live in the donut hole. For example, if HB 122 passes, but Representative Brian King’s (Democrat – Salt Lake City) HB 57 – Reproductive Health and Medicaid Amendments fails, a woman in the donut hole could afford treatment for postpartum depression, but not be able to afford the family planning services necessary to better ensure the child is entering a household that can nurture and raise the child.
Of all the versions of health care policy that could exist, this is, by far, the worst one that could exist short of no policy at all. The legislature simply does not have the time, expertise, or political capitol to spend on plucking individual health care treatments that should or should not be funded through Medicaid expansion.
An option does exist (for now anyway) that would alleviate this – full Medicaid expansion. Of course, with the newly minted president’s erratic nature towards the fate of the ACA, it is unclear if this will remain an option in the future, however what is certain is that the state has sat on such a policy for the past six years and an untold number of people have suffered because of its lack of implementation.
In-and-of-itself HB 122 is a good bill and should pass, however it represents a disturbing trend in state and federal health care policy that we as a state and nation should take a long, hard look at.
To contact Representative Redd, click here or call 435-760-3177
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