One in ten Georgians report knowing someone who has died through pregnancy-related causes. An estimated 57% of Georgians have experienced or know someone who has experienced maternal morbidity. Over 70% of Georgians believe that prioritizing improvements in access to health insurance coverage would help to reduce maternal mortality. These statistics were shared at the first annual Symposium to Address the Maternal Health Crisis in Georgia hosted by Emory University, Morehouse School of Medicine, Mercer University School of Medicine, and Research!America.
The United States has the highest maternal mortality rate among high-income countries and Georgia has one of the worst maternal mortality rates in the country with a rate of 33.9 deaths per 100,000 live births. While there are many reforms that can help Georgia to begin to address these challenges in maternal and infant health, full Medicaid expansion in the state should be a major strategy. Medicaid expansion is associated with lower rates of maternal mortality and may contribute to decreasing racial disparities in these areas. Research has shown there are multiple benefits for maternal and infant health associated with expanding Medicaid.
Georgia has passed the 12-month postpartum extension option under Medicaid, enabling more women to get needed care. However, the postpartum extension only covers women during pregnancy and up to one year postpartum. Preconception care also matters for maternal health and birth outcomes. Women who only gain access to coverage when they become pregnant bring untreated health conditions that put them at higher risk for adverse health outcomes. States that have taken up the Medicaid expansion option have seen their uninsurance rates plummet significantly and scores of analyses have linked expansion to improved financial security, access to care, health outcomes, and reduced disparities by race/ethnicity and income.
Georgia is one of the remaining 10 states that have yet to expand Medicaid. CCF analysis of the 2022 American Community Survey shows 17.7% of Georgia women between the ages of 19-44 are uninsured, well above the national average (10.9%) and among the highest uninsured rates in the country for women of child-bearing age.
In July 2023, Georgia started a very limited partial Medicaid expansion for adults up to 100% of the federal poverty line (FPL) through a section 1115 waiver. The program, “Pathways to Coverage”, requires Medicaid enrollees to meet work requirements and pay significant cost sharing - or be denied health coverage. As of mid-December, Pathways to Coverage “expansion” has only helped 2,344 people gain coverage.
In contrast, if Georgia opted to take on the full Affordable Care Act Medicaid expansion, 473,000 additional Georgians would gain healthcare coverage without added red tape. Georgia would also receive an estimated $1.2 billion one-time federal incentive bonus for expanding health coverage.
Expanding Medicaid in Georgia will not solve the maternal health crisis in its entirety, but the experience in other states shows it’s a necessary first step toward ensuring women are healthy before, during and after pregnancy. The state’s moms, babies and their families deserve no less.
Editor’s note: To maintain accuracy, Georgetown CCF uses the term “women” when referencing statute, regulations, research, or other data sources that use the term “women” to define or count people who are pregnant or give birth. Where possible, we use more inclusive terms in recognition that not all individuals who become pregnant and give birth identify as women.