This is a guest opinion column

Alabama faces a deepening prenatal healthcare crisis. According to the March of Dimes, 27% of Alabamians are unable to see a doctor within the first trimester. This delayed care increases the likelihood of serious complications for pregnant women and their children, possibly ending in tragedy for both.

Fortunately, there are practical steps we can take to address this healthcare gap and improve outcomes for moms and babies.

One obvious step is to provide quicker access to the health insurance such women are already eligible to receive. While Alabama has a process in place to help those who are pregnant apply for Medicaid if they are uninsured, the system is often fraught with delays that result in unnecessarily long waits before that first appointment. That’s why we have introduced a bipartisan bill to provide presumptive Medicaid eligibility, which would eliminate much of the lag time to that crucial first appointment with a doctor. HB 89, the Alabama Maternal Healthcare Act, will make it easier and more efficient for Alabama mothers to access prenatal care.

For those who become eligible for Medicaid due to a new pregnancy, the system for obtaining insurance is complicated. No woman can apply for the program without a pregnancy verification letter from a doctor, but many people cannot get in to see a doctor to get this letter because they do not have insurance. Many find themselves trying to schedule an appointment at a county health department or other free provider for this initial step, which can delay their application submission up to 45 days. It is only then that the patient can book their first prenatal care appointment, sometimes as long as eight weeks after first realizing they are pregnant, often well into their second trimester.

Delaying pregnant women’s initial appointment can have devastating effects on both mother and child. Early prenatal visits offer a baseline health check that can address any pre-existing health conditions or preventative care that had been delayed due to being uninsured. Patients can receive STI testing and treatment, blood pressure monitoring and medication, equipment for testing blood sugars to monitor for diabetes. Each of these health conditions don’t just hurt the pregnant patients but can cause miscarriage, stillbirth, and preterm labor that contribute to Alabama’s high rate of maternal and infant death.

With presumptive eligibility, a newly pregnant person who is uninsured will be financially screened to see if she is eligible for Medicaid. If she is screened as likely eligible for Medicaid, she can go ahead and start receiving prenatal care while her application is being processed and have a pregnancy test for confirmation at her first visit (without the extra step of obtaining the pregnancy verification letter).

First trimester prenatal care is considered a critical part of pregnancy care. Yet for far too many Alabamians, even this basic care is being denied to them simply because of a bureaucracy that is failing thousands of pregnant patients and their babies every year and some are even dying in the process. That is why we have made it our priority to introduce this bill to make Medicaid eligibility presumptive for those who are newly pregnant.

By passing HB89, we can vastly improve health outcomes with very little expense, saving millions of dollars by reducing preterm birth expenses. This bill is the best way we can show that Alabama really does care about our mamas and babies.

Rep. Susan Dubose, R-Hoover, and Rep. Marilyn Lands, D-Huntsville, serve in the Alabama Legislature.