One in Five Women of Reproductive Age Is Uninsured in Georgia

Largely due to the state’s decision not to expand Medicaid, Georgia has one of the highest rates of uninsured women of reproductive age (18-44) in the country with nearly one in five (19.3 percent) lacking health insurance. Georgia ranks 46th in the country and has the highest uninsured rate for women in this age group in the deep South apart from Mississippi (Florida has a similar rate). See Figure 1.

The Uninsured Rate Is Even Higher for Latinas and Other Groups

Women in this age range of all races in Georgia face high rates of uninsurance as compared to the national average (12.8 percent). White and Black women in Georgia are uninsured at similar rates; both groups are higher than the national average. Almost half (45.9 percent) of women of reproductive age who identify as Hispanic or Latina are uninsured in Georgia, and this is almost twice as high as the national average for Latinas. American Indian/Alaska Native (35.9 percent) and Multiracial/Other (38.0 percent) women also have very high uninsured rates. See Figure 2.

Poor Health Outcomes and Disparities for Georgia Mothers and Babies

The United States has a very high rate of maternal mortality (23.8 per 100,000 live births) compared to many of its peer nations, and Georgia’s rate (24.5) is slightly higher than the overall U.S. rate for the most recent year of data available (2020). Black women face much higher rates of maternal death (40.9) in Georgia as is the case elsewhere. Infant mortality presents similarly with Georgia babies dying at a rate of 6.1 per 1,000 live births, slightly higher than the U.S. average (5.2). Black babies die at higher rates (8.9) in Georgia than white babies (5.0) though this is lower than the national rate for Black babies (10.2).

Georgia’s Medicaid program is performing poorly on some key maternal and infant health metrics as compared to other states such as the timeliness of prenatal care, access to postpartum care, and the percentage of babies who have low birthweight. Georgia is in or near the bottom quarter of all states that report each of these metrics. Sixty-seven percent of Georgia babies are receiving all of their recommended well-child visits within the first 15 months of life, just over the national median of 66 percent in Medicaid and CHIP.

Although Georgia’s Medicaid program is performing poorly in most maternal and infant health metrics, these metrics look only at those women who are able to access Medicaid or CHIP as a parent or while pregnant. Many other women have no coverage at all as described above. These women are largely excluded because the state has not expanded Medicaid to adults as described above. This problem is compounded by the fact that Georgia’s Medicaid eligibility limit for parents is extremely low. A mother with two children would be over the income limit if she earns just $634 a month. In a positive development, the state has adopted the new option to increase postpartum Medicaid coverage to 12 months.*

*The postpartum option is not in effect yet because currently everyone who gave birth while receiving Medicaid since March of 2020 is retaining their coverage anyway due to the continuous coverage provisions associated with the COVID-19 public health emergency.