In a unanimous decision, Alabama lawmakers have passed a bill designed to provide faster access to Medicaid for pregnant women, reflecting a broader regional effort to reduce high maternal and infant mortality rates in Southern states. The โpresumptive eligibilityโ measure will enable Medicaid to cover outpatient medical expenses for expectant mothers for up to 60 days while their application for the government-supported insurance is processed.
The bill is now awaiting the signature of Republican Governor Kay Ivey. Many members of the Republican Party have shown strong support for the initiative, emphasizing its alignment with โpro-lifeโ values. Meanwhile, Democratic lawmakers have highlighted the critical need for this bill to address health outcomes related to childbirth in Alabama, which are currently not up to par with national standards.
Other Southern states like Mississippi and Arkansas have also implemented similar measures in an attempt to combat some of the countryโs highest rates of maternal and infant mortality. Research has shown alarming statistics, indicating that Alabama experienced a maternal mortality rate of 64.63 deaths per 100,000 births from 2018 to 2021, compared to the national average of 34.09 per 100,000 births. The figures are even more concerning for Black women in Alabama, with rates soaring to 100.07 deaths per 100,000 births.
Contributing to the problem is the closure of hospitals in rural areas of the state, leaving many women without essential prenatal care. Alarmingly, nearly 20% of pregnant women in Alabama last year delayed receiving prenatal care until after their fifth month of pregnancy or attended less than half of the recommended prenatal visits, according to The March of Dimes.
This situation partly arises from a substantial coverage gap, where one in every six women of childbearing age finds themselves earning too much to qualify for Medicaid yet too little to afford private insurance, as highlighted by Alabama Arise, a group advocating for families with low income. Alabama is among only ten states that have not expanded Medicaid coverage, limiting low-income womenโs eligibility primarily to when they become pregnant.
Currently, a pregnant woman with no dependents in Alabama qualifies for Medicaid if her income does not exceed $21,996. Those in a household of three can earn up to $37,704. In 2023, Medicaid was responsible for covering 45% of all births in the state, according to the latest report from the Alabama Department of Public Health. Moreover, over half of the infant mortality cases involved mothers who were Medicaid recipients.
The newly passed Alabama bill anticipates increasing Medicaid spending by approximately $1 million each year over a span of three years, with about two-thirds of the funding expected to come from federal contributions. Furthermore, another proposal advancing since March focuses on enhancing medical access for expectant mothers by permitting midwives to assist in deliveries at freestanding birth centers. However, amendments to this bill have sparked controversy, as they restrict midwives from conducting essential newborn medical screenings needed to identify genetic disorders.
The Alabama Midwives Alliance expressed their disappointment through a video on social media, noting that while the initiative began with good intentions, the recent amendments have steered it in an unfavorable direction.