The Importance of Medicaid Expansion to Women’s Reproductive Health

An unpublished Letter to the Editor about the importance of Medicaid Expansion to women’s reproductive health jointly written by Kendra Copanas and Michelle Trupiano

Michelle Trupiano is the Executive Director of Missouri Family Health Council, Inc., which provides oversight, training, and support to over 70 reproductive health clinics across the state.  

Kendra Copanas, Executive Director of Generate Health, which mobilizes and inspires the St. Louis region to advance racial equity in pregnancy outcomes, family well-being, and community health.  

Over the past several months thousands of Missourians have lost their jobs, income, and health insurance due to COVID-19. Research has proven the racial disparities in access to health care related to the disproportionate number of Black COVID-19 cases, hospitalizations, and deaths. At the same time, our communities are back in the streets fighting for racial equity. In the midst of all this, an opportunity to provide health coverage for 230,000 more Missourians was solidified for our state. Missouri has attempted, and failed, time and time again to pass Medicaid Expansion through the State Legislative process. This August, it is up to the people.

If passed, Medicaid expansion would mean substantial health gains for 230,000 low-income Missourians – many of them women – who do not have access to continuous coverage, including reproductive and sexual healthcare. Expansion is a key step to addressing the racial disparities in our healthcare system and would save thousands of lives.

There are stark racial disparities in women’s healthcare. Missouri Black moms are more likely to die in the perinatal period. Pregnant people are currently covered under Medicaid, but Missouri’s current restrictive eligibility for parents and childless adults means that many of these same women are uninsured in the crucial periods before and after birth. Access to coverage during these periods allows people to address chronic conditions such as hypertension and mental health issues that put future pregnancies at risk. The maternal mortality risk for Black women is three times higher than the risk for White women. Expanding Medicaid will reduce this disparity.

Those with continuous healthcare coverage are more likely to avoid care because of cost. Without routine care, illnesses, such as breast cancer, go undetected for longer periods of time. Black women are more likely to die from breast cancer than white women and early detection can play a role in reducing cancer related death.

Equitable access to women’s healthcare, including reproductive and sexual health services, prevents morbidity and mortality, enables women and adolescents to make the reproductive decisions that are best for them and their futures, and supports women to thrive and be healthy. We owe it to Missourians to do what our state legislature did not: expand Medicaid.

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