May 22, 2019

Utah Has Higher Uninsured Rate for Women of Childbearing Age  

New report Finds Medicaid Expansion Leads to Healthier Mothers and Babies

 A new report shows states that fully expanded Medicaid saw a sharp decline in the uninsured rate for women of childbearing age. Utah’s uninsured rate for women ages 18-44 was at 11.2 percent in 2017, according to a new report by the Georgetown University Center for Children and Families. In comparison, states that had implemented full Medicaid expansion had an average uninsured rate of only 9 percent. Utah recently received a waiver to begin partially expanding its Medicaid program. More Utah women will now be eligible for Medicaid coverage; however, following the decision of the Legislature and Governor to roll back the voter-approved expansion, thousands of residents will still remain without the health coverage they need, including prenatal care.

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 fully 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. “Medicaid expansion is the single most effective way to help women of childbearing age get continuous health coverage during this critical stage of life.”

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. In Utah, new mothers typically lose Medicaid coverage 60 days postpartum. 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, which can affect up to one in seven Utah women.

“As Utah begins implementing its partial Medicaid expansion, we know that there is more we can and need to do to make affordable health insurance available to all Utah residents.” said Jessie Mandle, Senior Health Policy Analyst with Voices for Utah Children. “When women are shut out of affordable coverage because they do not qualify for Utah’s partial expansion, or because they experience disrupted care, this impacts the whole family. This report makes clear that full Medicaid expansion, without caps, barriers or disruptions, is critical for the health and well-being of Utah moms and kids.”

See the full report: