We like to say that everything is bigger here in Texas, but that’s not always such a good thing. These days we have a Texas-sized problem with providing health insurance to women of childbearing age, and that means some babies are born less healthy than they could or should be.

If you’re a low-income woman between the ages of 19 and 44 in our state, your options for health insurance coverage are very limited. Non-pregnant women can obtain coverage through a Marketplace plan, but those earning less than 100% of the federal poverty level are not eligible for the tax credits to help them pay for coverage. As a result, many Texas women of childbearing age remain uninsured.

The greatest opportunities to improve the health of a woman and her child during pregnancy occur before she becomes pregnant. If a woman can obtain regular health care services prior to pregnancy, she is much more likely to have a healthy pregnancy and baby.

Improving the health of women of childbearing age could reduce our state’s Medicaid spending levels. In 2012 first-year medical costs were about 10 times greater for preterm infants ($32,325) than for full-term infants ($3,325). Thus, for every 1,000 fewer babies born preterm, approximately $29 million in first-year medical costs would be saved.

The March of Dimes dedicates millions of dollars every year to research on understanding and preventing prematurity, birth defects and infant mortality. But here in Texas, we already know at least one important thing we can do to improve the health of our state’s women and babies. Texas needs to expand medical coverage for these fellow citizens caught in a gap with no medical coverage.