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Worth Repeating: Pregnant Women, Infants, Young Children are NOT Protected in Proposed Medicaid Cuts

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Last month, the U.S. House passed the One, Big Beautiful Bill Act with an array of cuts to Medicaid and other critical supports for mothers, infants, and young children. Somehow, as Joan Alker described last week, the Senate version of the bill only made the prospects worse. Research shows that Medicaid coverage of pregnant mothers and young children has a long lasting, lifelong positive impact on health, education, and earnings outcomes. So Medicaid cuts, as the saying goes, are “penny-wise and pound-foolish.”

It is hard to overstate the critical role Medicaid plays for mothers and young children, covering essential services and supports and boosting family economic security. CCF fact sheets detail the ways Medicaid supports women, moms and newborns and young children. Others explain Medicaid support for early childhood programs and systems that support their earliest development (e.g. child care, child welfare, early intervention). Medicaid cuts put every one of these populations and their services at risk.

Let’s recap Medicaid’s importance to young families:

  • Pregnancy and postpartum coverage: Medicaid pays for more than 40% of U.S. births. While income eligibility levels vary by state, coverage for prenatal care, birth services, and 60-days of postpartum coverage are required core benefits. As of January 2025, 48 states and Washington, D.C., had opted to extend postpartum coverage to 12 months to ensure mom and baby have stable coverage during the year. 
  • Newborn Babies. When their births are financed by Medicaid, newborns have automatic and continuous coverage for one year. For the 12% of births covered by Medicaid that are preterm, Medicaid pays for life-saving services from a neonatal intensive care unit (NICU). For all eligible babies, pediatric primary care and other needed services are covered.
  • Young Children. Medicaid, along with the Children’s Health Insurance Program (CHIP), covers more than 40% of the nation’s young children under age 6, including three quarters of young, low-income children (those in families below 200% of the federal poverty level). In seven states, Medicaid/CHIP covers at least half of children under age 6 (AL, AR, KY, LA, MS, NM, OK). Under Medicaid’s child health benefit, EPSDT, these children and others gain access to well-child visits, acute care, and interventions to prevent disabilities.
  • Parents and caregivers, including child care providers. By raising income eligibility to cover low-income adults under Medicaid, the Affordable Care Act’s Medicaid expansion allowed more adults to have health coverage for the first time. This extended Medicaid to many low-income parents and others who care for their children. In 2023, nearly 30% of child care workers were covered by Medicaid—a critical support for working parents and the small businesses that employ them.

Here is what we know for sure: Cuts to Medicaid federal funding will hurt pregnant women and families with young children.

The sheer magnitude of the Medicaid cuts—most recently calculated at nearly a trillion-with-a-T dollars—severely threaten the health of young families. The risks of include loss of health coverage, more limited access to care, and family economic instability.

The pending bills target Medicaid expansion through work requirements and other red tape and would result in loss of coverage for millions of parents, adding new health and economic stressors. When parents get their health needs met, they are better equipped to focus on their child’s growth and development as well as to work to support their family.

Risks to child health from cuts to Medicaid expansion begin before they are conceived. Uninsured women are more likely to have untreated health conditions prior to pregnancy, which can place greater risks on a healthy birth. Medicaid improves access to recommended and effective interventions, helping more adults get their health, mental health and substance use disorder treatment needs met before pregnancy.

And where will these women have their babies?? Medicaid is a vital source of health coverage for women and children across the country, and it is particularly important to those living in small towns and rural communities, who already face challenges accessing needed care. As a major coverage source for rural Americans—including women of childbearing age— Medicaid provides essential financing for obstetric and other services in rural hospitals. Severe cuts to Medicaid would result in reduced coverage, declining Medicaid revenues, and increased uncompensated care costs for rural hospitals:

With rural hospitals or their OB units already declining, these cuts will force more pregnant women to travel longer distances to give birth. The proposed rural hospital funding meant to address rural hospital concerns would not make up for the losses from Medicaid cuts.

Last but not least, proposed cuts put state-optional Medicaid services and coverage groups at risk. New budget pressures are sure to emerge as states scramble to administer Medicaid with fewer dollars, putting various options on the table for rollbacks. The postpartum extension of Medicaid coverage to 12 months is optional, as is coverage for pregnant women above $138% FPL. An estimated 1 in 5 children is covered in CHIP or an optional Medicaid category. New services or provider types recently adopted by states—doula care, community health workers, home visiting, and school-based services—are all at risk of rollbacks as states are forced to balance their budgets with significantly less federal funding.

As young families already struggle, Congress is on the cusp of making things worse by putting their health care at risk and passing the most consequential budget decisions along to state leaders.

ccf.georgetown.edu