New Report Finds Medicaid Expansion Leads to Healthier Mothers and Babies

A new report shows Pennsylvania saw a decline 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 13.9 percent to 7.1 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.

“Pennsylvanians should be proud of this significant accomplishment as ensuring women have health coverage during this critical stage of life helps both mother and child,” said Joan Alker, executive director of the Georgetown University Center for Children and Families. “This report underscores the need to keep Medicaid strong, so women and their families have access to continuous health coverage.”

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 Kari King, President and CEO of Pennsylvania Partnerships for Children. “Medicaid expansion was a critical step forward to ensuring Pennsylvania children and families thrive, but there is more we can do to ensure optimal health for moms and babies. Here in Pennsylvania, we’re in the planning stages of building a comprehensive policy continuum to ensure an additional 25 percent of young children have access to high-quality programs and services that will improve their well-being.”

In April, Pennsylvania was announced a winner of the Pritzker Children’s Initiative (PCI) Prenatal-to-Age-Three State Grant Competition, which awarded cross-sector coalitions in 11 states with planning grants to develop and strengthen high-quality prenatal-to-age-three services. The prenatal-to-age-three coalition will leverage public and private partnerships to build on the critical ongoing investments for the 432,580 infants and toddlers across Pennsylvania.