Opinion: The reality and needs of maternal health in Connecticut

Hartford Courant – Wednesday, March 5, 2025
By Dr. Khuram Ghumman, Brian Riley and Mark Schaefer

Experience tells us that sometimes even well-intentioned changes can have unintended consequences.

But when patient health is at stake, these consequences can be dire. The state of Connecticut is changing the way that doctors get paid for providing maternity care to low-income people covered by HUSKY Health (Connecticut’s Medicaid program) that is meant to improve health outcomes and health equity in Connecticut. We are concerned that the change won’t achieve these goals, and worse, will only leave more people covered by the program unable to get the prenatal care they need.

We understand and agree with what the state is trying to achieve with this policy change, specifically attempting to address the growing maternal health disparities experienced by people who get their healthcare through HUSKY Health.

When it comes to this critical health coverage, we are proud of what our state offers. But we are still missing the mark at improving overall maternal health outcomes. We must do more to address this maternal health crisis.

We know that the causes of the crisis are many and complex, and there is no one solution. We’ve also learned that more than 80 percent of deaths during and after pregnancy in the U.S. are preventable – an alarming statistic.

Here in Connecticut the consequences are heart-wrenching. Since 2010, women covered by HUSKY Health were more likely to have complications during or after pregnancy, or even death. In fact, between 2015 and 2020, there were 80 pregnancy-associated deaths in Connecticut.

That’s 80 families who lost a mother, a daughter, a sister—an unthinkable tragedy.

We also know that Black and Latino women are more likely to suffer a severe complication or die than women of other races, which means this loss is disproportionately impacting those communities.

We agree with the state that we need to do better for our neighbors. But the proposed solution could make things worse by making the practice of maternal health care less financially sustainable. In essence, the model presented for HUSKY Health increases the services to be provided to patients and extends coverage later in the postpartum period—both good things—but it does not assure that the payment ob-gyn practices receive will be anywhere near adequate for the care they provide.

We support increasing access to care for our patients. We know, for example, that incorporating screening for social determinants of health and expanding the patients’ care teams to include doulas can help our patients tap into resources and support that are proven to improve their health and well-being.

And we know that dangerous complications can emerge well after delivery, so increased access to care after childbirth can absolutely be life-saving.

The problem, quite simply, is one of mathematics. The cost of providing health care continues to grow. Medical practices are not immune to inflation. And more medical interventions cost money. All of the good intent of this policy needs to be matched by financing that will make the policy work.

Our fear is that faced with the stark reality of providing more care without compensation, some practices may be forced to stop accepting HUSKY Health patients.

We want to be able to do right for our patients. We want to connect them with the resources that are available to help them have healthier pregnancies. We agree with the findings from the Connecticut Maternal Mortality Review Committee, a group of dedicated, qualified experts who recommended community-level connections to make sure that people get the care and support that is right for them as individuals, based on their needs, values, and priorities.

HUSKY Health is working hard to make a difference in the health and lives of our pregnant and postpartum patients. Unfortunately, as designed, the state’s new payment model jeopardizes access to care for HUSKY Health patients seeking maternity care. It is critical that we all continue working together – healthcare providers, government partners, policymakers, and patient advocates – to ensure that the state’s policies achieve our shared goals of increasing access and improving health outcomes.

Khuram Ghumman, MD, is president, Connecticut State Medical Society. Brian Riley is chair of the Connecticut Section of the American College of Obstetricians and Gynecologists. Mark Schaefer is vice president of System Innovation and Financing, Connecticut Hospital Association.

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