Christie should allow state Medicaid expansion

Marian Seliquini, Lawrenceville 
To the editor:
This past summer the New Jersey Legislature passed A2795, a bill to expand Medicaid family planning services to individuals with incomes up to 200 percent of the federal poverty level. This translates to just under $40,000 for a family of three, and it is the same level of eligibility used for pregnant women. Governor Christie vetoed this bill on September 11. The governor cites fiscal responsibility as the reason for his veto, yet there is no evidence to support this position. Rather, his veto is another attack in what has become a consistent war on family planning and women’s health since taking office in 2010.
Family planning services include basic health care services crucial to women’s health: gynecological exams, screening for cervical cancer and breast cancer, testing and treatment for sexually transmitted infections, HIV testing and counseling, contraception, and basic health screenings (diabetes, hypertension, and weight management). Family planning services do not include abortion of any kind—whether by surgical or medical procedure.
Why should we expand Medicaid family planning services? Because the research shows that these programs work. They improve the health of our population and they make good fiscal sense. When states expand Medicaid family planning services, they experience decreased rates of unintended pregnancy, teen pregnancy, and abortion. More women receive health care, and rates of contraception use rise. Expanded Medicaid family planning programs are either cost-neutral to states enacting them or else cost-effective. In fact, both the federal and state governments can expect to benefit from savings over time—family planning service are much cheaper to provide than the costs associated with providing care for unintended pregnancies.
The benefits of expanding eligibility for Medicaid family planning services are so well-recognized that the Affordable Care Act included a new provision—the State Plan Amendment—that allows states to more easily change their Medicaid programs in this direction. The CDC lists Medicaid family planning expansion as a strategy to reduce teen pregnancy rates, and Healthy People 2020 includes a goal to increase the number of states with such expansions.
Twenty-nine states have already taken the opportunity to expand Medicaid family planning services. New Jersey should join them—we need it. According to the Guttmacher Institute, 54 percent of all pregnancies in New Jersey in 2008 were unintended. Of these unintended pregnancies, 39 percent resulted in birth, and 49 percent resulted in abortion (the remainder resulted in miscarriage).
We should support proven measures that reduce the rate of unintended pregnancy and abortion. When such a health policy is shown to decrease government costs over time, how can we go wrong? Our elected representatives in the Assembly and Senate have recognized the wisdom of Medicaid family planning expansion. Governor Christie needs to step out of the way and stop playing politics with New Jersey’s health.
Marian Seliquini 
Lawrenceville 