Expanded access to Medicaid was associated with 1.6 fewer maternal deaths per 100,000 women compared with states that didn't expand the program, according to a new study. The infant death rate also fell more dramatically in Medicaid expansion states—by more than 50% from 2010 to 2016.
Those findings were in a report released Wednesday by the Georgetown University Center for Children and Families.
Researchers found that expansion states saw greater drops in the uninsured rate among women ages 18 to 44 and fewer racial healthcare disparities compared with the 17 states that have yet to expand.
"There's no one answer to improve our care for women of childbearing age and mothers," said report co-author Adam Searing, associate professor of the practice at Georgetown's Center for Children and Families. "But we do have a clear place where we can start and that really is expanding Medicaid coverage in the states that haven't yet expanded and maintaining good Medicaid coverage in the states that have."
Studies suggest African-Americans most benefited from Medicaid expansion. The report cited a 2018 study published in the American Journal of Public Health that found the mortality rate among African-American infants declined by 14.5% from 2010 to 2015 in expansion states, which was more than twice the decline of the rate among African-Americans in states that didn't expand Medicaid.
Congressional Democrats in recent months introduced legislation to address the large racial disparities in maternal health outcomes. African-American women are three times more likely to die of complications related to pregnancy and childbirth than white women.
Those types of disparities have contributed to the U.S. having the highest maternal mortality rate of any developed country in the world, with 26.4 deaths for every 100,000 live births in 2015 compared with 7.3 deaths in Canada, 7.8 in France, and 8.8 deaths in England.
The report released Wednesday found there are many black women living in states that have not expanded Medicaid, making it more difficult for them to access maternal care.
"Clearly states can change this egregious reality by expanding Medicaid," said Lucia DiVenere, senior director of government affairs for the American College of Obstetricians and Gynecologists.
A report released in early May by the Centers for Disease Control and Prevention found 3 out of 5 pregnancy-related deaths in the U.S. were preventable, with roughly a third deaths occurring one week to one year after delivery.
Earlier this month, presidential candidate Sen. Corey Booker (D-N.J.) introduced legislation that would extend Medicaid coverage for postpartum care from two months to 12 months.
"Coverage is the first step to ensuring that women have access to the pre-pregnancy care, prenatal care, and continuous quality postpartum care that are vital to good health," DiVenere said.
