November 17 is World Prematurity Day. It gives us, as health professionals, an opportunity to direct our attention to a devastating health issue that impacts 15 million babies each year and rededicate ourselves to reducing that number. Several organizations, including ACOG, are supporting the cause through education, awareness, and advocacy events. However, there’s one event in particular that, coincidentally, started this week and stands to make the most significant impact in terms of lowering the preterm birth rate in this country and that’s open enrollment through the Health Insurance Marketplace.
Prevention of preterm birth starts with a healthy mom and that means access to prenatal care and preventive services. There are several risk factors for preterm birth, some of which include high blood pressure, low pre-pregnancy weight, alcohol and drug abuse, smoking, a prior preterm birth and a birth less than 12 months ago. Adequate health insurance coverage can make the difference between a pregnant woman carrying to term or delivering too early and the Affordable Care Act has helped make that coverage accessible to millions of women.
Between 2010 and 2015, the U.S. Department of Health and Human Services reported that the uninsured rate among women aged 18-64 decreased by 44 percent. And during the 2016 enrollment period alone, 6.8 million women and girls gained coverage. So, they now have access to critical services, including well-woman visits, folic acid supplements, and screening and/or counseling for anemia, gestational diabetes, tobacco use, and domestic violence. And as of two years ago, all plans include maternity care, which is considered one of the 10 essential health benefits.
Whatever your reservations may be regarding the various provisions of the law, its tremendous impact is undeniable. However, we still have a great deal of work to do in making sure certain populations don’t continue to fall through the cracks. According the Kaiser Family Foundation, approximately 11 percent of women in 2015 were uninsured and they were disproportionately low-income, immigrants and women of color. These are the very same populations that are the most at risk for preterm births. Reaching the groups in the coverage gap will be a difficult obstacle to overcome but each year during open enrollment we get closer to making sure every woman and baby has access to affordable health care and that’s progress.