Medicaid pays for 30 percent of all births in Utah, said Stephen McDonald, a spokesman for the Utah Department of Health.

Unlike Medicaid assistance for the elderly and disabled, the prenatal and postnatal programs haven't been limited.

Some students see prenatal Medicaid as a blessing, as they struggle to pay tuition and other expenses while coping with pregnancy. Others are concerned students may be abusing the program.

"We support Medicaid," said graduate student Matthew Gross. "We just think it should be used for the needy. I think our main problem with it is that BYU students see it as a free thing. It's advertised that way from mouth to mouth."

For someone to qualify for prenatal Medicaid assistance in Utah, their household income must be below 133 percent of the federal poverty level -- 33 percent higher than the income allowed for the elderly and disabled to receive aid.

At this rate, many BYU students technically qualify for Medicaid, but graduate student Missy Gross said qualifying isn't the same as needing.

"I work in the hospital and see people who really can't afford health insurance and don't qualify for Medicaid," she said. "I think most students can sacrifice a little, just give up a cell phone or eating out, and pay for insurance."

BYU graduate Lauren Richins said she agrees that Medicaid has potential for abuse, but doesn't believe students should feel guilty for using Medicaid if they qualify.

"I figured [the government] set the limit so people who have enough money won't qualify," Richins said. "We didn't have a new car or furniture, so I figured getting government help to pay medical bills was a good thing. I think if someone qualifies, they shouldn't feel bad for using [Medicaid] because for the next forty years of their life they're going to be paying it back in taxes."

Still, BYU graduate Tami Varner said she struggled with the decision to accept Medicaid assistance.

"At first I thought I was being a bad citizen," she said. "I thought I was just taking from the government. But having a baby is so expensive, I don't think we could have done it without Medicaid. I figured, 'If you need it, why not use it?' That's what it's there for."

Richins said Medicaid saved her family thousands of dollars in debt.

"My husband had just broken his hand the year before," Richins said. "We had just finished paying debts from those surgery bills when I got pregnant."

Richins said she and her husband were signed up for BYU health insurance and intended to use that until they graduated in December.

"We planned on graduating a month before the baby was born," Richins said. "My husband started work at the beginning of January, so we thought we'd have our baby in California and be on Boeing insurance."

At her mother's suggestion, Richins applied for Medicaid as a precaution.

She was lucky she did.

On Halloween night, three months before their baby was due, Richins went into labor.

"It was so weird because my pregnancy had been so smooth up to that point," she said.

To save the baby, doctors kept Richins in the hospital for a week, then confined her to bed rest until her daughter, Megan, was born 51/2 weeks later. They kept Megan in intensive care for two additional weeks.

"Medicaid was really a blessing for us," Richins said. "Any time I would have contractions during those 5 1/2 weeks, I would go straight to the doctor or the hospital. It was really nice not to have to worry about the cost. And sometimes there was a complication that needed to be cleared up right at that point. I think having Medicaid helped in making sure our baby went as long as possible."

Richins said Megan is three months old now "and getting fatter by the minute."

Graduate student Ephraim Washburn said Medicaid exists to cover emergencies like the one Richins faced.

"Sometimes it's too much to cover yourself," Washburn said. "If the baby goes into ICU, if the mother has complications, if the baby is born premature or the mother needs to stay in the hospital for awhile. For those people, it's great.

"For most people, though, I think paying for pregnancy just takes planning. My wife and I are expecting our third child and have never used Medicaid.

"I have some friends who make even less money than me, but have had three babies, all delivered by C-section, without using Medicaid. C-section deliveries are a lot more expensive because you stay there longer and have to pay operation fees. But they didn't want to use Medicaid, so they looked for other options. I think it's in your attitude."



Copyright Brigham Young University 21 Mar 2003