Texas has the highest rate of uninsured women in the country, and one of the highest death rates for pregnant women and new mothers. ProPublica and Vox just spent past eight months going through all of the data and reports, reviewing medical records and talking to providers and women and family members to determine how those two factors interact, particularly for women of color.
What they found was a lot of heartbreaking stories and "a system of staggering complexity, riddled with obstacles and cracks, that prioritizes babies over mothers, thwarts women at every turn, frustrates doctors and midwives, and incentivizes substandard care." One expert, Eugene Declercq, professor of community health sciences at Boston University School of Public Health, calls it "the extreme example of a fragmented system that cares about women much more in the context of delivering a healthy baby than the mother's health in and of itself."
Here's one example: Brittney Henry, just one of the women who makes up the 40% of post-partum deaths that occur six weeks or more after giving birth. A few weeks after she had her fourth child, Henry had a heart attack, one of the most dire of complications possible following birth. The 28-year old had a stent put in and got the necessary prescriptions, covered by pregnancy Medicaid. But pregnancy Medicaid only lasts a few months after birth, and when it ended for Henry, it was fatal. Without insurance, she could not keep up with her medications. Five months after giving birth, Henry collapsed and died before a neighbor could bring her to the emergency room.
Texas is the stingiest of all the states when it comes to Medicaid eligibility. A "single mother with two children only qualifies if she earns the equivalent of 17 percent of the federal poverty level or less—$230 to $319 per month, depending on who’s doing the calculation." Pregnant women are eligible for coverage at 198% of the federal poverty level—$3,520 a month for a family of three—but that pregnancy Medicaid only applies as long as they're serving as a vessel for the all-important fetus. Alison Stuebe, a professor of obstetrics and gynecology at the University of North Carolina School of Medicine says that reflects the screwed up pro-life attitude not just in Texas, but in society. "If a woman’s value is 198 percent of the federal poverty level when she’s pregnant and 17 percent of the federal poverty level when she's not, that means we're saying a nonpregnant woman is worth 91 percent less than a pregnant woman."
Medicaid expansion in the Affordable Care Act was supposed to have prevented that from happening—all people at 198% of poverty would have been eligible, but Supreme Court Chief Justice John Roberts couldn't let that happen. His very political choice to make Medicaid expansion optional for the states has resulted in this: dead women. Completely preventable deaths, in many cases. Like Rose Diaz, who didn't go to the emergency room when one of her fallopian tubes was exploding from an ectopic pregnancy, and who died at age 43.
This could be different. The U.S. could join the rest of the advanced economies of the world and provide universal health care. Instead, we have a system in which women are four times more likely to die from complications of childbirth than in comparable countries. We have a maternal death rate that is growing—113% in the past three decades. It's time for that to change. And it's time for women to have as much worth in our society as their offspring.