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More equitable care for Colorado's pregnant moms

Updated: Aug 25, 2021

While this past year has been marked by grief, loss, and tragedy, we are coming out on the other side of the pandemic stronger, with many lessons learned and mistakes never to be repeated. One of the largest challenges re-exposed by the pandemic are the deep-rooted racial disparities that continue to plague our healthcare system – both in Colorado and across the country. COVID-19 disproportionately devastated communities of color, and although we are turning a corner, we must continue to work toward creating an equitable health care system for all Coloradoans. This includes access to the highest quality prenatal and maternal care for every mother in the Centennial State.

We have both long focused on eliminating the disparities in our health care system — disparities that are especially stark in our prenatal and maternal health outcomes. In fact, almost 700 people die every year in our country due to pregnancy-related complications, with Black mothers dying at a rate that’s three times greater than white women. To be sure, we have made and continue to make progress. Just this legislative session, the two of us guided into law SB21-193 and SB21-194, bills designed to eliminate disparities in care for all people from pregnancy through one year postpartum. Through the process of sponsoring these bills, we learned that we have only just begun to scratch the surface and that there is still much work to be done.

One of the things we have learned is that some Black and Brown mothers in Colorado lack access to the safest and most accurate prenatal screening options available. These screenings – known as non-invasive prenatal testing (NIPT) – allow expecting mothers to identify genetic abnormalities in their babies. Compared to traditional screening options, NIPT has a much higher accuracy rate of detecting common genetic abnormalities in babies during pregnancies. It also has a much lower rate of producing false positive results, sparing many mothers the additional unnecessary stress and high cost that come with more potentially invasive tests.

Research published in the distinguished New England Journal of Medicine, along with leading medical societies, all agree: NIPT should be offered as a prenatal screening option to all pregnant people, regardless of their risk factors. And yet, so many of our state’s pregnant women continue to lack access and informed consent for these safer and more accurate tests with appropriate counseling before the screening. This can be particularly true for those who receive their health benefits through our state’s Medicaid system.

Currently, among Colorado mothers who receive Medicaid benefits – nearly half of whom are Black, Hispanic, or Native — only those deemed “high-risk” — have access to NIPT. This, compared to most private insurers that provide NIPT coverage to all women regardless of risk factors. This kind of disparity is what we aim to address with our new birth equity laws – which were informed by Coloradans and we want members of our community to continue to inform implementation — so that our Black and Brown communities will no longer find themselves disproportionately left behind and without access to the best care available.

Policy makers and elected officials in Colorado like ourselves have repeatedly pledged to dismantle the systemic racial inequities that still exist in our state, including in health care — and we must continue to listen and be responsive to our community to address these inequities. We must implement the laws that SB 193 and 194 set into action, including ensuring that Health First Colorado, our state’s Medicaid Program, reimburse for care that is high-quality, cost-effective, evidence-based, and prevents risk in subsequent pregnancies, such as covering NIPT for all pregnant people. With these laws, we can begin to head in the right direction toward health equity for all Coloradoans.

Janet Buckner, an Aurora Democrat, represents District 28 in the Colorado Senate and previously served in the state House of Representatives. Leslie Herod, a Denver Democrat, represents District 8 in the Colorado House of Representatives and currently serves as chair of the Black Democratic Legislative Caucus and the House Appropriations Committee.

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