Report: States Without Medicaid Expansion Have Higher Maternal, Infant Death Rates

May 22, 2019

A new report shows that in Florida - one of 14 states that did not expand Medicaid - the uninsured rate for women of childbearing age is more than twice as high as the average for Medicaid expansion states. 

This means a higher rate of maternal deaths and infant mortality.

Adam Searing, the lead author on the report by the Georgetown University’s Center for Children and Families, said there's no one answer to improved care for women of childbearing age and mothers, “But we do have a clear place where we can start and that is expanding Medicaid coverage in the states that haven't yet expanded, and maintaining good Medicaid coverage in the states that have."

Expectant mothers apply for Medicaid coverage after finding out they’re pregnant, which could be weeks after conception.

Searing said insurance allows women to see a doctor both before and after they're actually pregnant - allowing for better prenatal care, and help for chronic conditions like hypertension and depression.

The report says a lack of Medicaid expansion is especially deadly for black women and babies.

Lucia DiVenere, Senior Director of Government Affairs at the American Congress of Obstetrics and Gynecology, said this racial disparity has not narrowed in decades.

“Notably, many of the states that have not expanded Medicaid also have the highest populations of black residents,” DiVenere said. “We know that black woman die from pregnancy-related complications at a rate that is three to four times higher than white women."

From the report:

“The uninsured rate among nonelderly African Americans is 14 percent in states that haven’t expanded Medicaid compared to 8 percent in expansion states. Nonelderly white children and adults (ages 0-64) experience lower overall rates of uninsurance: 10 percent in states that haven’t expanded Medicaid compared to 6 percent in expansion states.18 In Southern states, which make up the majority of those that have not expanded Medicaid, African Americans are disproportionately affected and experience higher uninsured rates. This is due in large part to the fact that the states that have not expanded Medicaid have larger shares of black residents.”

In states that have expanded Medicaid, not only did birth-related mortality rates decline, but they declined much more dramatically among black mothers and infants.

Florida has one of highest uninsured rates at 19% for women in this age group and extremely low Medicaid eligibility levels for parents.

Read the full report from Georgetown University’s Center for Children and Families, The March of Dimes and the American Congress of Obstetrics and Gynecology here.