Ask Congress to Ensure Funding for Birth Centers

September 29, 2008

The American Association of Birth Centers has issued an appeal to supporters to contact Congress concerning a payment crisis that threatens insurance support for birth centers around the country.

After more than 20 years of providing funding, the Centers for Medicare and Medicaid Services (CMS) — the federal agency that runs Medicare/Medicaid — is now refusing to pay the federal percentage of Medicaid payments that states might make to birth centers.

“This is not a Medicaid crisis but a payment crisis for birth centers,” according to the AABC. “Historically all payers follow the lead of Medicaid.  If Medicaid stops paying the birth center facility fee so will other insurers.”

The AABC explains the background:

Over the past few years, CMS has begun disallowing federal matching funds for state Medicaid payments for freestanding birth center services. Birth centers have been recognized by CMS (and earlier, by HCFA) as a Medicaid provider type in State Medicaid Plans since 1987.

Recently, however, CMS has disallowed such payment by several state Medicaid Agencies, including Alaska, South Carolina, Texas, and Washington State, claiming that it lacks clear statutory authority and direction to do so. CMS has directed its regional offices to stop federal payments to any state for birth center services.

This action by CMS puts pregnant women at risk of losing access to safe, high quality maternity care.

Visit AABC for more information on how to contact your member of Congress and urge legislation to direct CMS to pay birth center facility fees. It would be great if midwives, women who have used birth centers and anyone who believes in the right to choose her own birth site got involved.

Here are some facts about birth centers:

  • Birth Centers are part of a vital safety net for Medicaid mothers across the U.S.
  • Birth centers fill the void left in many areas when hospitals — rural, urban or suburban — close their obstetrical services
  • Many rural and urban birth centers serve a disproportionately high percentage of Medicaid recipients. Texas provides two examples – at least 95% of patients in an inner city Houston birth center, over 85% for a center in Weslaco, Texas in the Rio Grande Valley
  • Birth centers have a proven history of reducing low birth weight and preterm birth, the main causes of neonatal death in the U.S.
  • Birth centers provide innovative approaches to maternity care that reduce disparities for low-income and minority women, lower cesarean section rates, and reduce health care costs
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