Prenatal care is among the top concerns local obstetricians’ and gynecologists’ offices are concerned with if next Tuesday’s referendum fails to pass.

If passed, the amendment would allow lawmakers to move nearly $146 million each year over the next three years from the state’s oil and gas reserves to the general fund budget, helping to alleviate cuts to state programs and agencies.

The General Fund provides tax dollars to non-education agencies such as the state’s court and prison systems, the Department of Public Safety, the Department of Mental Health, the Department of Public Health and the state’s Medicaid program.

Additionally, the General Fund provides for food safety, and funding for rural fire departments and first responders – law enforcement, firefighters and paramedic services.

For doctors and staff at Covington Obstetrics and Gynecology, the top concern is patient care for their maternity patients.

“People are going to continue to get pregnant and without Medicaid some have no way to pay for proper care, and without it some won’t get prenatal care,” Cindy Pollock of Covington OBGYN said. “It would be devastating. SOBRA Medicaid was created in 1988, hoping to help women seek prenatal care because Alabama was either first or second in infant mortality rate.”

In Alabama, Medicaid coverage is available – called SOBRA – for pregnant women and children who meet certain eligibility requirements including being a pregnant woman, a child under 19, an Alabama resident, and meeting certain income guidelines.

At Covington OBGYN, Pollock said that of the total patient population, meaning all patients who use the practice, some 22 percent have Medicaid, and 2.7 percent are maternity patients. Of the total maternity population, 73.8 percent have Medicaid, either as their only method of payment or as secondary to commercial insurance.

Pollock said that percentage rises to 79.4 percent countywide.

“These percentages are somewhat skewed by the fact that many of the local insured patients choose to go out of town to Enterprise, Dothan, Montgomery or Pensacola for their maternity services,” Pollock said. “The majority of the patients who have Medicaid as their secondary payer are children who are covered under a patient’s insurance plan, but do not have coverage for maternity services.”

Pollock said that all Medicaid maternity patients are required to enroll with the Gift of Life Foundation and are required to use GOLF providers. GOLF administers all claims and is responsible for paying all providers from the time the patient is enrolled through 60 days following delivery.

Additionally, every child born to a Medicaid-eligible mother is automatically eligible for Medicaid until its first birthday.

If the Sept. 18 referendum fails to pass, Pollock said, they have already contacted Rep. Mike Jones, R-Andalusia, to see what the specific cuts would be.

In total, Medicaid is responsible for approximately 30 percent of total payment received by the practice.

Pollock said as of May 1, reimbursement for all services was reduced by 10 percent in anticipation of the projected shortfall in Medicaid funds, and that the reduction was expected to last through September, but has now been extended through Dec. 31.

“If this amendment does not pass, many Alabamians will have no health care coverage, with the majority of those being expectant mothers and children,” Pollock said. “Our capacity to provide care to these patients will be greatly diminished. Worst case scenario, we will be forced to restrict the number of Medicaid patients we accept.”

Pollock said that some doctors will be forced into early retirement, while others will be forced to cut staffs, which would increase the wait time for many patients to set appointment times.

“If this doesn’t pass, it’s going to be bad,” she said.

Polls will be open Tuesday from 7 a.m. until 7 p.m.