New Report Finds Medicaid Expansion Leads to Healthier Mothers and Babies

A new report shows Arkansas saw one of the sharpest declines in the uninsured rate for women of childbearing age following the state’s decision to expand Medicaid.

Between 2013 and 2017, the uninsured rate for women ages 18-44 declined from 26.3 percent to 11.4 percent, according to a new report by the Georgetown University Center for Children and Families.

Medicaid expansion has played a key role in reducing rates of maternal death, decreasing infant mortality rates, and improving the potential for optimal birth outcomes that can increase the promise for a healthy childhood, according to the report. States that expanded Medicaid saw a 50 percent greater reduction in infant mortality, compared to non-expansion states.

“Health coverage before, during and after pregnancy is essential to the health and well-being of both mother and child,” said Joan Alker, executive director of the Georgetown University Center for Children and Families. “We know that thousands of Arkansans lost coverage due to the punitive work reporting requirement in 2018 and at least half of those who lost coverage were likely women. Thankfully a court ruling stopped the work reporting requirement, giving Arkansas a chance to get back on track.”

States that have expanded Medicaid have also decreased the likelihood that women’s eligibility for coverage fluctuates, resulting in losing and regaining coverage over a relatively short span of time. Breaks in health coverage, also known as “churn,” can disrupt care and cause existing health conditions to become more serious and more difficult and expensive to treat, according to the report.

“The message of this study is clear: Medicaid expansion can protect the lives and health of women and their babies, especially women of color who are at higher risk for a range of poor outcomes,” said Dr. Rahul Gupta, Senior Vice President and Chief Medical and Health Officer at March of Dimes. “If mom isn’t healthy, then her baby is at higher risk for a whole host of health consequences. If she’s healthy, however, that baby has a much higher likelihood of getting the best possible start in life.”

The American College of Obstetricians and Gynecologists recommends that women have access to continuous coverage prior to becoming pregnant and 12 months postpartum to reduce preventable adverse health outcomes.

“OB-GYNs have long recognized that continuous, quality and affordable medical care is vital to the health and wellbeing of our patients,” said Barbara Levy, M.D., Vice President of Health Policy at ACOG. “This important research demonstrates that Medicaid expansion plays a critical role in reversing the steadily rising rates of maternal mortality in the United States by ensuring women have access to the care they need before, during and after childbirth. As many as 60 percent of maternal deaths are preventable. Therefore, ACOG encourages both expansion and non-expansion states to continue working toward Medicaid policies that fill the gaps in coverage to improve health outcomes for women and babies.”

Research shows that health coverage prior to pregnancy helps address risk factors such as obesity, diabetes and heart disease and improves access to timely prenatal care. When mothers abruptly lose health coverage so soon after giving birth, it can force women to abandon medication or other ongoing treatment they may need, including support for postpartum depression.

“Medicaid has helped more women gain access to the care they need before, during, and after pregnancy, improving their health and the health of their newborns,” said Loretta Alexander, Health Policy Director at Arkansas Advocates for Children and Families. “At a time when thousands of Arkansans have lost critical Medicaid coverage due to work reporting requirements, this report proves how important it is to eliminate any barrier that stands between health insurance and families.”