State Lawmakers Urge Medicaid Expansion to Fight Maternal Mortality Crisis

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A bipartisan panel of Georgia lawmakers recommended that the state expand Medicaid coverage for poor and rural mothers, a move they said could help lower the state's high maternal death rate.

The state of Georgia could improve its maternal mortality rate by extending the amount of time that low-income mothers are eligible for Medicaid, a bipartisan panel of lawmakers said this month.

“With over 50% of the births in Georgia covered by Medicaid, limited postpartum Medicaid coverage is also an access-to-care issue,” says a report issued by the state’s House Study Committee on Maternal Mortality. “Medicaid pays for medical care for pregnant women until 60 days after they give birth; however, this does not cover all the needs of a pregnant woman postpartum.”

That recommendation is one of 19 made by the committee, created last year after reports that Georgia had the worst rate of maternal death in the United States, which in turn has the worst rate among industrialized nations. In Georgia, the committee found, 26 women die from pregnancy complications for every 100,000 live births, compared to 17 nationwide. Roughly 60 percent of those deaths were preventable, according to the report, and the problem is much worse among black women, particularly those who live in rural areas.

“Rural African American women have double the maternal mortality rate of white rural women. Additionally, rural African American women have a 30% higher maternal mortality rate compared to their urban African American counterparts, and rural white women have a 50% higher maternal mortality rate than their urban white counterparts,” the report says. “For these rural populations, the risk associated with demographics are layered, interconnected, and complex and relate back to the fundamental barriers to healthy outcomes that rural women face. These barriers include the availability of transportation, supportive organizations, and social services.”

Expanding Medicaid coverage could help, the committee said. Low-income pregnant women in Georgia are currently eligible for Medicaid coverage for up to 60 days after giving birth, but most maternal deaths occur up to six months postpartum. Extending Medicaid coverage to a year after birth would allow women who need health care to continue getting services, the report says.

Georgia is one of 14 states that has not expanded Medicaid under the Affordable Care Act. Gov. Brian Kemp has proposed a limited expansion of Medicaid if it was implemented along with work requirements. Kemp has argued this would provide a way to help poor people get out of poverty, while "incentivizing employment," while critics in the state have urged the administration to embrace full expansion of the health insurance program.

Other recommendations from the maternal health report include mandated postmortem reviews for all maternal deaths up to a year post-pregnancy, increased pre- and post-natal care in county health departments, and increased efforts to combat obesity, which can complicate pregnancy outcomes. 

It’s unclear whether the state lawmakers, who head back to Atlanta this week for a new legislative session, will act on the committee’s recommendations. Most would require additional funding at a time when Kemp is requesting budget cuts across state departments. But state Rep. Sharon Cooper, a Republican and member of the study committee, told NPR that she had not received “negative feedback” from the governor’s office on the recommendations and maternal health advocates said that the bipartisan report proved that the issue warranted additional resources.

“The state has made major investments in maternal and infant health program and research funding in the past two sessions,” Elise Blasingame, executive director for Healthy Mothers, Healthy Babies Coalition of Georgia, said in a statement. “This list of recommendations from the committee further supports the critical need to keep that funding in place given the current budget climate and governor’s calls for cuts.” 

Kate Elizabeth Queram is a Staff Correspondent for Route Fifty and is based in Washington, D.C.

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