Medicaid and Reproductive Health

Since 1965, Medicaid has helped provide affordable health insurance coverage to people with limited incomes and resources in the United States. However, politicians have tried to shrink and dismantle the program.

Who Gets Hurt from Attacks on Medicaid

All people need and deserve equal access to comprehensive health care, including sexual and reproductive health care. But without Medicaid, tens of millions of people couldn’t access a wide range of health care services. That includes dental care, mental health care, and sexual and reproductive health care — such as birth control, family planning, annual exams, prenatal/maternity care, breast and cervical cancer screenings, and STD testing and treatment.

Groups facing discrimination and systemic oppression in the health care system are more likely to have low incomes and more likely to use Medicaid — including people of color, LGBTQ+ people, people with disabilities, and women. These groups would be the most hurt by losing access to Medicaid. The free and low-cost health insurance coverage that Medicaid provides particularly helps women access essential health care.

Medicaid, Women, and Families

• Approximately one in five women of reproductive age across the United States use Medicaid to access no-cost, essential health care. That’s 16.75 million women ages 19 to 49.

• Of the adult women who are enrolled in Medicaid, about two-thirds are in their reproductive years.

• Medicaid is also the largest payer of reproductive health care coverage, paying for 75% of all public funds spent on family planning services like birth control. 

• Medicaid is the source of coverage for prenatal care, delivery care, and other essential pregnancy care for 42% of people giving birth.

Medicaid and Women of Color

Racism and discriminatory public policy have created systemic and economic barriers that make Black women and Latinas more likely to have low incomes and be enrolled in Medicaid than white women. Medicaid coverage also is critical to closing the gap in health care access for women of color. 

• Due to systemic barriers, 31% of Black women and 27% of Hispanic women ages 15 to 44 are enrolled in Medicaid, compared to 16% of white women. 

• Among Americans under 65 who receive Medicaid, more than 11 million are Black and 16 million are Hispanic.

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% more likely to die from cervical cancer and 243% more likely to die from pregnancy- or childbirth-related causes than white women. 

• Black women and Latinas make up more than 80% of women living with HIV/AIDS. 

Medicaid coverage for pregnancy, birth control, and other sexual and reproductive health issues is critical in helping to close the devastating gap in health outcomes for women of color.

Medicaid and LGBTQ+ Communities

Discrimination and harassment also leave LGBTQ+ people disproportionately likely to live in poverty or without health coverage. 

• Collectively, LGBTQ+ people have a poverty rate of 22% — much higher than the 16% rate for cisgender straight people. 

• 24% of lesbian and bisexual women experience poverty, compared to 19% of heterosexual women. 

• Among LGBTQ+ community, transgender people have an especially high rate of poverty: 30%.

• 28% of transgender people say they have experienced discrimination and harassment in accessing health care.

• 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

Cuts to Medicaid significantly affect Planned Parenthood patients, nearly half of whom get their health care through Medicaid.

Every year, 2.4 million people rely on Planned Parenthood health centers for essential health care services, like birth control and lifesaving 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 patients are blocked from using Medicaid to access 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, Texans’ access to women’s health services declined drastically — with as many as 44,890 fewer women accessing health care.
• Despite the Texas program’s failure, a previous administration put federal dollars back into the program in January 2020. This move upended longstanding federal law. Before, the federal government refused to fund state Medicaid programs that aimed to take away the right of Medicaid patients to get care from the reproductive health care provider of their choice.

Attacks on Medicaid — and Women’s Health

Extreme politicians have waged attacks on Medicaid. They have consistently endangered up to 72 million people with Medicaid coverage — who are disproportionately women of color.

These attacks include cutting trillions of dollars from the program, limiting the ability of people to make decisions about their health care, and greenlighting stigmatizing proposals, like work requirements, that cause people to lose coverage.

Medicaid and Work Requirements

Medicaid work requirements are another way that politicians take critical health coverage away from people with low incomes. Prior to COVID-19, these discriminatory requirements caused thousands of people to lose their Medicaid coverage. Several states have adopted, and more states tried to adopt, Medicaid work requirements.

Medicaid work requirements do not help people to find employment and are ineffective in lowering unemployment. Work requirements also push people off of Medicaid. Here’s how:

• Work requirement policies force people to work and adhere to frequent, burdensome, detailed reporting in order for them to obtain and keep their Medicaid coverage. 

• Many people who’d lose Medicaid coverage because of work requirements are actually working or trying to work, but have irregular hours, can’t navigate reporting procedures (often due to lack of internet access and language barriers), or simply do not know about the new requirements. 

• On top of this, research confirms that Medicaid coverage itself helps individuals to obtain or maintain employment.

Work requirements for Medicaid block access to needed health care and services, particularly for women. 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.

Why We Must Fight for Medicaid

Without Medicaid, too many Americans — disproportionately women of color — would be unable to access basic health care.