For over 50 years, Medicaid has helped provide affordable health insurance coverage to people with limited incomes and resources in the United States. Without this joint federal-state program, too many Americans — disproportionately women of color — would be unable to access basic health care. This includes birth control, family planning, STI testing and treatment, well-woman exams, and life-saving cancer screenings. All people need and deserve equal access to comprehensive health care, including sexual and reproductive health care.
Medicaid, women, and families
Approximately one in five women of reproductive age rely on Medicaid to access no-cost, critical reproductive health care such as birth control, life-saving cancer screenings, and maternity care. Medicaid is also the largest payer of reproductive health care coverage, paying for 75 percent of all public funds spent on family planning services. Finally, for nearly half of women giving birth, Medicaid is the source of coverage for essential care, including prenatal and delivery care.
Medicaid and women of color
Racism and discriminatory public policy have created systemic and economic barriers that make Black and Latina women more likely to be low-income and have Medicaid coverage than White women. Approximately 30 percent of Black women and 24 percent of Latina women ages 15 to 44 are enrolled in Medicaid, compared to 14 percent of White women. Among Americans under 65 who receive Medicaid, nearly 11 million are Black and 18 million are Latino.
Those same systemic and economic barriers have made it disproportionately difficult for many people of color to access health care. As a result, people of color have worse access to reproductive health care — and worse health outcomes. Black women are 71 percent more likely to die from cervical cancer and 243 percent more likely to die from pregnancy- or childbirth-related causes than White women. And Black and Latina women make up more than 80 percent of women living with HIV/AIDS. Medicaid coverage is critical in helping to close the devastating gap in health outcomes for women of color.
Medicaid and LGBTQ communities
Due to systemic barriers — like discrimination and harassment in accessing health care, which 28 percent of transgender people say they have experienced — LGBTQ people are more likely than non-LGBTQ people to be living in poverty and to be uninsured. Twenty-four percent of lesbian and bisexual women experience poverty, compared to 19 percent of heterosexual women. Transgender people are four times as likely to be living in extreme poverty, making under $10,000 a year. This makes Medicaid a vital program for the health of LGBTQ communities. Thanks to Medicaid expansion, over 500,000 lesbian, bisexual, and gay people gained health care coverage under Medicaid between 2013 and 2016.
Medicaid and Planned Parenthood
Every year, 2.4 million women, men, and young people rely on Planned Parenthood health centers for essential health care services, like birth control and life-saving cancer screenings. Many of these patients — particularly women of color and people in rural or medically underserved areas — are covered by Medicaid and would have nowhere else to turn to for care if Medicaid patients are blocked from accessing care at Planned Parenthood.
States like Texas have suffered serious public health consequences after communities lost access to Planned Parenthood. After Texas forfeited its Medicaid family planning program and created a state-funded program that excluded Planned Parenthood and other similar providers, Texas women’s health declined drastically — with at least 30,000 fewer women and as many as 44,890 fewer women accessing health care.
Attacks on Medicaid
The Trump-Pence administration and extreme politicians have waged attacks on Medicaid. They have consistently endangered over 68 million people with Medicaid coverage — who are disproportionately women of color. This includes cutting trillions of dollars from the program, limiting the ability of women to make decisions about their health care, and greenlighting stigmatizing proposals, like work requirements, that kick people off of coverage.
Medicaid and work requirements
Medicaid work requirements, which the Trump-Pence administration is encouraging states to adopt, are just another way to allow discrimination against women with low incomes and take away critical health coverage. Work requirements will take women and families backwards by blocking access to needed health care and services. In fact, almost two-thirds of those who could lose Medicaid coverage due to work requirements are women. This stems, in part, from the fact that women are more likely to provide informal and undervalued caregiving or have low-wage jobs that do not provide health care coverage.