More than a dozen young mothers and their children looked on as the House Wednesday voted to advance a bill mandating that health insurers in Vermont offer maternity benefits for midwife services. The bill also requires that parents notify hospitals of the planned home births in advance, so that the hospitals can be better prepared to handle any complications that might lead to transport.
Chris Pearson, P-Burlington, explained the purpose of the bill. “We’re making policy consistent by mandating that insurance covers home births delivered by certified midwives. Right now, that’s already practiced by the Vermont Health Access Plan and Medicaid; we’re just extending that to private insurance.”
Pearson said that the House Health Care Committee heard testimony that home births save money, compared with hospital births. Nonetheless, he said, “Insurers were not necessarily in favor of this, but they acknowledged that there was no implication for rates.”
Home births are a well-established practice in Vermont, Pearson argued, pointing out that Vermont had certified midwives for 10 years, and that on a per capita basis Vermonters choose home births more than any other state. Twenty-three midwives are certified in Vermont, he said, and last year they conducted about 118 home deliveries.
With the state’s health insurance landscape in transition, the new mandate also sets the groundwork for eventual coverage of midwife services under Green Mountain Care, the state’s single-payer health care plan.
Rep. Tom Stevens, D-Waterbury, spoke warmly of his wife’s “two-and-a-half home births.” One of them was not successful at home, so at 3 a.m. on a “cold, cold, cold” winter day, they piled into their cars and went to the hospital to finish it. Under the bill, hospitals would be better prepared for visits like this.
Current law requires that home births occur in locations that are within a 30-minute drive of a hospital. The bill also requires the midwife to file a transportation plan with the hospital.
A number of representatives raised questions about the bill or midwifery, while voicing their support for the underlying intent of the bill. It was unclear whether Rep. Duncan Kilmartin’s rambling address was in favor of the bill or against it. The Republican representative from Newport touched on Columbus’ advisers, supposed Chinese-caused, 36-hour blackouts in Niagara Falls and Florida, Supreme Court support for reproductive freedom, and how he grew up in a family without a car.
“Look,” he concluded, “conceiving is a personal choice, and how you give birth and where you give birth is a fundamental liberty protected by the Constitution of the United States. What (sic) are we wasting time on this nonsense?” Supporters of the bill offered no response.
The bill also establishes a panel to investigate causes of deaths to mothers each year and compile overview information, and it creates a statewide network for information about newborns who need special care.
Part of a vital records bill was inserted into the midwifery bill, designating how a new birth certificate may be issued for someone who has undergone a sex change operation.
The bill was moved forward by the House on a voice vote, with a scattering of nays. To pass the legislature, the bill needs one more affirmative vote from the House, before it goes back to the Senate. The Senate may vote to concur with the amended version from the House or request a conference committee to work out the differences.
