Posts published in “Day: July 7, 2023”

Last week, on July 1, Idaho state government left its old fiscal year and entered a new one, which means a new state budget has taken effect.

There have been changes. One of the smallest, almost microscopic in dollar amount, has gotten little attention in the state. But it could turn into a matter of life and death, and it could make Idaho notably dangerous (well, more so) for women who become pregnant or have children. And it’s worth mentioning here as a point of context that, as researchers worldwide have noted, “The United States has one of the highest rates of maternal mortality among high-income countries.”

What we’re talking about is the state’s Maternal Mortality Review Committee, an advisory and information-gathering group, set up within the state Department of Health and Welfare, and what it looks into is deaths associated with pregnancies. The committee includes physicians and other medical personnel, a coroner, a social worker and others; the broad-based analysis of the medical data is what makes this panel different from simply collecting the raw information and filing it away.

It is inexpensive in state terms, barely there, amounting to possibly $15,000 by one estimate, but most or all of that is paid for by federal funds; it has been estimated to be revenue-neutral for Idaho government. The idea is “to learn from and prevent future maternal deaths.”

A national report on the committees’ work said “The United States can best save lives and prevent harm by thoughtful and strategic practices that honor states’ unique contexts and needs, and at the same time adopt a cohesive approach that leverages all of the data we collect on maternal deaths. MMRIA also provides support to reviews that take on challenging emerging issues, such as maternal suicide, drug overdose, and intimate partner violence, in the form of scientific and practice-based resources and tools.”

Idaho was not on the cutting edge here; the efforts to launch the committees started in 2015 with a national health industry initiative. In fact, every other state, plus some other jurisdictions, has similar committees. (Utah and Wyoming share one.)

It was set up in 2019; the legislature decided to end it effective a week ago, leaving Idaho as the only state which doesn’t have one of these multidisciplinary committees looking into which deaths related to pregnancies occur.

The derailing of the Idaho effect now amounts to truly weird timing, coming at a point when the legislature is crawling all over the subject of regulating - and changing the law in relation to - pregnancies.

In a sense, we should recognize that the raw numbers involved are not large; but they do represent the life and death of real people and our ability to learn from them. The most recent annual report from the group said “Seventeen women died in Idaho while pregnant or within one year of pregnancy. Sixteen of these deaths were reviewed by the MMRC … Fifteen deaths were determined to be preventable. Nine of the deaths were determined to be pregnancy-related.”

You have to wonder what the numbers will look like this year and next.

So why did the legislature kill the health review?

It was not inadvertent. Debate was substantial in the House Health and Welfare Committee, and a bill to continue the committee was considered but did not get the votes to progress.

One news story from KFF Health News said, “Idaho lawmakers decided not to advance a bill that would have embraced the committee’s recommendation to expand postpartum Medicaid coverage.”

The Idaho Freedom Foundation said the committee “would do little except be used as a vehicle to promote more government intervention in health care.” Of course, the committee has no lobbyists.

Or maybe, when it comes to finding out why pregnancy-related deaths will be occurring in Idaho in the coming year and more, maybe the legislature, with its now deeply-rooted responsibility in exactly that question, would rather not know.

In contrast to 49 other states.