WASHINGTON, DC (May 19, 2020)—The increase in U.S. maternal mortality is a public health crisis, but states that accepted the Affordable Care Act’s Medicaid expansion saw maternal mortality rise more slowly than did states not expanding Medicaid. That is among the findings of a study selected as the Editor’s Choice for the May/June issue of Women’s Health Issues.
Women’s Health Issues is the official journal of the Jacobs Institute of Women’s Health, which is based in the Department of Health Policy and Management at Milken Institute School of Public Health (Milken Institute SPH) at the George Washington University.
Erica L. Eliason, of the Columbia University School of Social Work, used 2006-2017 data on births and maternal deaths to calculate maternal mortality ratios—the number of maternal deaths per 100,000 live births—for each state in each year, and used a difference-in-difference approach to compare ratios in the 31 states and the District of Columbia that had expanded Medicaid by 2017 to the 19 states that had not done so. Because one of the problems the U.S. faces is racial disparities in maternal mortality, she calculated separate ratios for non-Hispanic Black, non-Hispanic White, and Hispanic women.
Eliason found that Medicaid expansion states saw seven fewer maternal deaths per 100,000 live births when compared to non-expansion states, but the gap for Black women was substantially larger, at 16 maternal deaths.
“The effect of Medicaid expansion on maternal mortality was concentrated among non-Hispanic Black mothers, indicating that Medicaid expansion could be contributing to a reduction in the large racial disparity in maternal mortality faced by Black mothers,” she explained. “The findings in this study underscore the importance of health insurance coverage in improving maternal outcomes and the crucial role that expanded Medicaid access could be playing in decreasing devastating disparities in maternal mortality in the United States."
“This study provides important evidence that expanding Medicaid can improve maternal health and reduce racial disparities,” said Amita Vyas, Editor-in-Chief of Women's Health Issues and Associate Professor of prevention and community health at Milken Institute SPH. “I hope policymakers in the states that have not yet expanded Medicaid see these findings and consider maternal health in their decisionmaking.”
“Adoption of Medicaid Expansion is Associated with Lower Maternal Mortality” has been published in the May/June issue of Women’s Health Issues.