To the Journal editor:

A baby born in the Upper Peninsula and a baby born in Ann Arbor arrive with the same theoretical access to care, but the U.P. baby’s mother may have driven past two hospitals that couldn’t deliver her child, rationed gas money between appointments and groceries, or spent her third trimester relocated hours from home. By the time her baby arrives, the gap is already wide and it has almost nothing to do with the care received.

That is why the expansion of Rx Kids to the Upper Peninsula deserves the full attention of policymakers, health systems, funders and insurers. The U.P. has been making do without this kind of investment for too long.

Rx Kids provides cash support to pregnant women and mothers of infants, starting with a lump sum prenatally and continuing with monthly payments through the first six months of life. It started in Flint with a straightforward premise: poverty is one of the greatest predictors of poor birth outcomes and financial stability in those early months produces measurable returns in health and economic participation.

Philanthropic funders and insurers don’t often find themselves in the same conversation, but Rx Kids puts them there. From a philanthropic perspective, we look for multi-system returns. Children born into economic instability are more likely to have poorer health outcomes, and those outcomes are expensive. The cost of one child falling behind far exceeds what Rx Kids invests in a family each month. For Superior Health Foundation, this kind of cascading impact is exactly what a long-term investment is supposed to produce.

Insurers arrive at the same conclusion from a different direction. A single NICU stay costs an average of $71,158, an amount that could support 15 U.P. families through Rx Kids. But it isn’t only about dollars. Health plans want their members to thrive. Chronic prenatal stress, driven by financial insecurity, is a documented contributor to preterm birth and perinatal complications. Rx Kids gives families a cushion to attend appointments, fill prescriptions, and buy adequate food.

From a Medicaid health plan perspective, Rx Kids is one of the most powerful ways to help moms and babies truly thrive. These dollars go directly toward essentials that make healing and bonding possible: diapers, utilities, transportation, rent, and baby supplies. Upper Peninsula Health Plan case managers actively promote the program and walk expectant parents through enrollment. We see the impact daily. One pregnant member enrolled and immediately expressed deep gratitude for the financial support and connection to community resources. Another, a pregnant unhoused mother of three, was helped to enroll by a community health worker; those monthly payments will be critical for groceries and transportation. We hear these stories directly from moms, often through tears of relief. For us, Rx Kids isn’t just a program. It’s a lifeline that gives families dignity, stability, and a stronger start.

In the western U.P., women cross into Wisconsin for care unavailable in Iron or Gogebic County. Others fly out of small regional airports for high-risk obstetric services that don’t exist locally. In Ontonagon County, where there is no emergency department and the nearest labor and delivery unit is over an hour away, women late in pregnancy are routinely advised to go stay somewhere else and wait.

The financial toll of that travel is largely invisible in the data. Gas, lodging, missed work and lost wages compound the hardship. Rx Kids doesn’t solve the distance problem, but it removes the financial barrier that causes women to delay or skip care entirely. That delay is where health outcomes decline and costs increase.

The earliest months of a child’s life are where investment matters most. The real story of Rx Kids is being written in communities across the U.P., one family at a time. It deserves to be told that way.