Medicaid takes a big bite of the state budget. In these tight times, there’s no meat left on the bone in Georgia’s treasury.

State legislators face tough decisions when they return to the Gold Dome in January. They must further trim expenses amid continuing shortfalls. Finding a way to hold down Medicaid costs – without reducing crucial benefits – looms as one of their greatest challenges.

Moving prenatal care from Medicaid to PeachCare for Kids may provide one solution.

Sounds like a bureaucratic puzzle, I know, but this small change could pay large dividends.

Both of these health care programs are funded by federal/state cost-sharing. But not all programs are funded equally. The federal government pays 62.4 percent of Georgia’s Medicaid costs. The state picks up the other 37.6 percent. In PeachCare, by contrast, the federal government pays 73 percent of the cost, leaving the state with a much smaller cost.

In 2001, the Medicaid program spent $286 million on health care for pregnant women, of which Georgia paid $108 million. Transferring much of this cost to PeachCare could save the state approximately 28 percent on prenatal care expenses.

Medicaid provides health care to low-income Georgia families. It provides prenatal care to women at or below 235 percent of the federal poverty level. This means a family of three can earn over $35,000 a year and a family of four can earn $42,000 a year and still be eligible. (After babies’ births, Medicaid covers families at or below 185 percent of the federal poverty level, and the percentage drops as the child ages.)

PeachCare for Kids began in 1999 after Congress created Title XXI of the Social Security Act to provide health care for the growing number of uninsured children in the United States. This legislation provided states with the opportunity to create programs to increase access to affordable health insurance. The Georgia General Assembly answered that call with PeachCare.

PeachCare for Kids offers comprehensive health care to children through the age of 18 who do not qualify for Medicaid and live in households with incomes at or below 235 percent of the federal poverty level.

The Bush administration early in its term expanded the scope of programs such as PeachCare. The guidelines issued by Health and Human Services Secretary Tommy Thompson allow for children’s health care programs to cover a child from the moment of conception. Before, the coverage could not begin until the actual birth of the child.

If the state switches some prenatal care from Medicaid to PeachCare, it will be able to provide the same level of coverage for pregnancies, but at a lower cost.

During my last session in the state Senate in 2002, I authored a bill to allow prenatal care under PeachCare. The state Senate passed that legislation but a state House committee failed to act. At the time, the state was awash in revenues and the state House leadership seemed more concerned about appeasing the pro-choice advocates than saving the state money.

If it weren’t for the political posturing and positioning in the abortion debate, treating a fetus as a human in need of health care would be a no-brainer. As an Ob/Gyn for 28 years, I delivered more than 5,200 babies. The process of ensuring a healthy baby doesn’t begin when the doctor cuts the umbilical cord. It begins at conception, and mothers and their babies need access to care – which often can prevent costly illnesses or prolonged, expensive hospital stays after the babies’ births.

In tough economic times, legislators have to make tough decisions. Don’t let this common sense approach to maximizing federal dollars get caught up once again in the abortion debate. This would be a losing argument against a win-win idea to help relieve our Medicaid funding crisis.

Phil Gingrey represents Georgia’s 11^th Congressional District.