As the Republicans of the federal government continue to work to overhaul the nation's health care system, Americans with all kinds of specific health care needs are watching their progress (or lack thereof) anxiously. This includes pregnant women, who would stand to see their insurance premiums jump dramatically if any version of the bill that the GOP had proposed so far were to become law. The latest Senate plan to dismantle the existing Affordable Care Act (ACA) has collapsed, though, leaving the country with the status quo — for now. Still, being pregnant in this country can be tough on the wallet regardless — as conditions in states that are worst for pregnant women indicate.
After his failure to garner enough Republican "yes" votes to pass a repeal and replace bill though the Senate for the second time earlier this month, Senate Majority Leader Mitch McConnell wants senators to vote on a bill whose contents are shrouded in mystery this week. But a previous (failed) version of the bill could have seriously weakened the mandate that says all plans must cover maternity care, and could have forced women to pay more than $1,000 more per month for such coverage. It throws into sharp relief how inhospitable this country can be to new and expectant moms.
For now, at least, the ACA is still the law of the land. And variations still exist state-to-state in how easy or difficult it is to be pregnant and have a baby. The below list is a sampling of where it can be tough. It's not comprehensive.
In August 2016, the personal finance website WalletHub used data from sources ranging from the U.S. Census Bureau to the Environmental Protection Agency to the Centers for Disease Control to determine the best and worse states to have a baby. Mississippi ranked dead last, and it was also among the bottom five when it come to states with the highest infant mortality rate; and fewest midwives, OB-GYNs, pediatricians, and family doctors per capita. The state's two Republican senators, Thad Cochran and Roger Wicker, have both earned a 0 percent from the Planned Parenthood Action Fund for consistently voting against women's health interests. So did its three Republican representatives in the house, with the lone Democrat scoring 100 percent.
In another comprehensive analysis in May 2017, WalletHub determined that Alabama is the state that is the absolute worst for working moms. It ranked 47 out of all 50 states plus Washington, D.C., for having among the worst day-care systems. It also has one of the highest gender wage gaps and its female-to-male executive ratio is among the worst. Sens. Bill Cassidy and John Kennedy, both Republicans, also both scored 0 percent with the Planned Parenthood Action Fund.
Back in 2015, the Institute of Women's Policy Research ranked South Dakota last in the reproductive rights category of its "Status of Women in the States" series. According to The Washington Post, variables the researchers considered included "access to, funding for and political support for abortion; sex education; and whether a state imposed any of a variety of abortion restrictions."
Twice as many pregnant women and new moms died in Texas in 2012 than in 2010, the Dallas News reported. One study determined that infections, heart attack, and bleeding to death were responsible for some of the deaths. But the state does not share information about this problem, citing patient confidentiality issues. That makes it difficult to address, as Dr. Robert Gunby, acting chair of the department of obstetrics and gynecology at Baylor University Medical Center, told the newspaper.
They say they’re trying to protect patient privacy, but they could just cross out patient names and any identifiers. We've got to be able to get access to the data and to see why these deaths are occurring and why we're different to California where things are improving.
This, of course, does not bode well for pregnant women in Texas.
Louisiana has the unhappy distinction of holding the second-to-last spot on both of WalletHub's analyses. So, it's one of the worst states in which to have a baby and the one of the worst for working moms. It ranks 47th for highest infant mortality rate (with the higher states ranking the worst) and 49th for fewest pediatricians and family doctors per capita. It tied with Alaska for 49th for the highest gender pay gap and 48th for the worst daycare systems. Unsurprisingly, the state has two Republican senators, both of whom hold a score of 0 percent with the Planned Parenthood Action Fund.
Watching how senators vote as the fight over health care continues to rage will show how much they're willing to protect pregnant women's access to care. This information from various studies and reports offers a good indication of other factors that make a state friendly to pregnant women — or not.