Written by Steve Lowe, President and CEO Dallas-Fort Worth Hospital Council, March of Dimes Texas Chapter State Advocacy and Government Affairs Committee Member

We like to say that everything is bigger here in Texas, but that’s not always such a good thing. These days we have a Texas-sized problem with providing health insurance to women of childbearing age, and that means some babies are born less healthy than they could or should be.

If you’re a low-income woman between the ages of 19 and 44 in our state, your options for health insurance coverage are very limited. A woman isn’t eligible for Medicaid unless she’s pregnant.

Many Texas women of childbearing age remain uninsured. Over the years 2010-2012, an average of 33%, or one in every three, women of childbearing age in Texas had no health insurance, according to the National Center for Health Statistics, putting us near the bottom of the national rankings.

This situation represents a real missed opportunity, not only for those women but for their babies. The greatest opportunities to improve the health of a woman and her child during pregnancy occur before she becomes pregnant.

If a woman can obtain regular health care services to help quit smoking, achieve a healthy weight, and maintain normal blood pressure and blood sugar levels, she is much more likely to have a healthy pregnancy and baby.

This situation has serious implications for our state’s Medicaid program because many of these women become eligible for Medicaid coverage once they become pregnant. Medicaid currently covers 54 percent of the births in Texas, making it a major payer for maternity services. Research has shown that complex births are covered disproportionately by Medicaid. Nationally, Medicaid paid for over half (53 percent) of all hospital stays for preterm and low birthweight infants, and about 45 percent of infant hospital stays due to birth defects in 2009.

Improving the health of women of childbearing age could reduce our state’s Medicaid spending levels. According to the Birth Report from the National Center for Vital Statistics, in 2012 first-year medical costs including both inpatient and outpatient care, are about 10 times greater for preterm infants ($32,325) than for full-term infants ($3,325). Based on these estimates, for every 1,000 fewer babies born preterm, approximately $29 million in first-year medical costs would be saved.

While some argue that the Marketplace is a viable substitute for covering this population, this option leaves a considerable proportion of women of childbearing age with no feasible way to obtain insurance.

The March of Dimes dedicates millions of dollars every year to research on understanding and preventing prematurity, birth defects and infant mortality. But here in Texas, we need to expand medical coverage for these residents caught in a gap with no medical coverage.

This piece originally appeared as an op-ed in the Star-Telegram.