Both state Senate and House legislative panels rejected the expansion of Medicaid benefits to more than 900,000 Florida residents, despite the recommendation from Gov. Rick Scott to do so as part of the state’s plan to implement the Affordable Care Act (ACA).

Sen. Joe Negron, chairman of the Senate’s special committee on the ACA that rejected the expansion March 11, indicated the body is moving towards developing a Florida-specific plan, which could potentially mean providing vouchers or subsidies to a portion of the eligible population instead of full expansion. The House has also suggested they may develop their own plan.

Scott wanted to implement the expansion for the next three years while the federal government is picking up the costs.

Women age 15-44 years old have the highest uninsured rates in the state. Nearly one-third of women who gave birth in 2010 had no health care coverage prior to their pregnancy.

The state Medicaid program pays for nearly half of all births in the state. Currently, Medicaid provides coverage for uninsured pregnant women with incomes up to 185% of the federal poverty level. Benefits, however, end 60 days following delivery except for family planning services which are offered under a special state waiver slated to end in 2014. Expanded Medicaid benefits for pregnant women have significantly improved access to prenatal care, increasing the chances of a healthy birth and reducing the need for costly NICU care.

A growing body of evidence, however, suggests access to care during pregnancy is important but not sufficient for improving the health of mothers and babies. Poor maternal health before pregnancy has been linked to prematurity and low-birthweight, particularly among African Americans. Maternal health issues prior to pregnancy is consistently the factor most frequently identified in Fetal and Infant Mortality Reviews (FIMR) conducted by the Coalition. Improved preconception health is a priority focus of the U.S. Centers for Disease Control and Prevention and a key strategy implemented by the Magnolia Project to address health disparities.