Infant mortality: An intolerable Florida tragedy

An unconscionable paradox exists in America, and especially in Florida.

It is made up of the politicians who advocate stridently for life in the womb but care not nearly so much, if at all, whether babies, once born, will live healthy or die.

A Florida law enacted last year will effectively ban virtually all abortions if the Supreme Court upholds an earlier statute that prohibits them after 15 weeks.

And yet, Florida newborns are less likely to survive to a first birthday than infants in 50 foreign countries and nearly half the other U.S. states.

An intolerable tragedy

Sun Sentinel reporter Cindy Krischer Goodman described this intolerable tragedy in a March 21 special report, “Born to die: Florida’s infant mortality crisis.”

Six of every 1,000 babies born in Florida, she wrote, will die before their first birthday, a rate slightly higher than the national average, which was 5.6 per 1,000 in 2022 according to the Centers for Disease Control. That statistic is among the worst in the developed world.

It’s more than three times as high as in Slovenia, Singapore and Iceland, which are the safest countries for newborns, according to CIA World Factbook statistics.

The survival rate is even worse for Black babies, who die in Florida twice as often as white non-Hispanic and Hispanic infants. There are no acceptable reasons for that.

A little help, but not much

It’s not that Florida hasn’t done anything about this. The state offers prenatal care to low-income women who are otherwise uninsured — that is, if they can find out about it. But when we clicked on the Department of Children and Families link while writing this, the computer answered, “Sorry, this page is not available.”

They must already be pregnant to qualify.

Even that help is too little and too late for many women whose babies will die.

The same Legislature that extols the unborn refuses to expand Medicaid as authorized by the Affordable Care Act to some 800,000 people under 65 who would be eligible under the new threshold of 138% of poverty, which is set at $20,782 this year for a single adult.

“Health experts say the losses of new life will continue unless the state rethinks how it fails mothers before and during pregnancy,” Goodman explained. “The biggest risk to an infant’s health is always the mother’s health.”

“Everything from Florida’s impenetrable insurance structure to its ineffective treatment in maternal and prenatal health contributes to the high rate of babies who die within their first year of life, sometimes within their first minutes,” Goodman wrote.

No moral justification

Infant mortality statistics include stillbirths as well as premature deliveries. Untreated chronic conditions heighten the risks, nearly doubling the chances that the baby will be born too early or dead.

There is no moral justification for a political system that makes women wait until they are already pregnant for the preventive medical care that can reduce infant mortality.

Florida is one of only 10 states, all governed by Republicans, that have refused the Medicaid expansion for which the federal government pays 90% of the cost.

As enacted, Obamacare made expansion mandatory, but the Supreme Court barred that in a decision that stopped short of fulfilling the Republican goal of repealing the entire program.

The decision created a coverage gap, leaving people like those 800,000 Floridians ineligible for both original Medicaid and Obamacare’s insurance marketplace subsidies.

Arkansas did, but not us

Most Republican-led states in the West and Midwest have expanded Medicaid either by legislative action or voter initiative. So have Louisiana, Arkansas and, this past December, North Carolina.

That option was conspicuously absent from the “Live Healthy” program successfully advanced by Senate President Kathleen Passidomo during the Florida Legislature’s recent session and signed by Gov. Ron DeSantis.

While they make more aid available to community health clinics that are the last resort for uninsured childless adults, their main purpose is to train more doctors and other health care professionals to cope with an ever-aging population.

The package includes $134.6 million to increase Medicaid reimbursement rates for hospitals that treat mothers and babies during labor and delivery. That’s all good, but it does nothing about the care so many women aren’t getting before they become pregnant.

Florida’s Medicaid rolls have been shrinking as the state drops families who could not be disenrolled during the federal government’s declared COVID-19 health emergency.

Some are being kicked out because their family income is now too large for basic Medicaid. But others are being disenrolled simply because they didn’t receive or respond to renewal notifications from the state.

Too many kids disenrolled

So far, more than 1.3 million Floridians, including 460,000 children, are without the Medicaid coverage they had last year.

The state insists everyone was properly notified, but Xavier Becerra, secretary of the U.S. Department of Health and Human Services, has written to DeSantis and seven other governors about the disenrollment of so many.

“It continues to not just disturb but confound, I think, a lot of folks that some states have chosen not to address the loss of health care by so many children,” he said.

In Florida, however, the people who most need to be disturbed and confounded — the governor and legislative leaders — don’t appear to care.

They should want to know why — as our Orlando Sentinel colleague Caroline Catherman reported — more than nine times as many children have been disenrolled from Medicaid as have been newly enrolled in Florida’s KidCare program, which is subsidized insurance if their parents earn too much to qualify for Medicaid.

How a society cares for its children is a striking measure.

By that standard, Florida stands in shame.

The Sun Sentinel Editorial Board consists of Opinion Editor Steve Bousquet, Deputy Opinion Editor Dan Sweeney, editorial writer Martin Dyckman and Editor-inChief Julie Anderson. Editorials are the opinion of the Board and written by one of its members or a designee. To contact us, email at letters@sun-sentinel.com.