In Mississippi, where the abortion case that ended Roe v. Wade brought to the Supreme Court, Governor Tate Reeves swore that the state now “take every step necessary to support mothers and children.”
Today, however, Mississippi is doing poorly by just about any measure for that purpose. Infant and maternal mortality rates are among the worst in the nation.
State leaders have rejected the Medicaid extension of the Affordable Care Act, causing an estimated 43,000 women of childbearing age without health insurance. They chose not to extend Medicaid to women for a year after giving birth. And they have a welfare program that gives some of the country’s least generous monetary aid – a maximum from $260 per month for a poor mother raising two children.
Mississippi embodies a national pattern: States that have banned, or expect to have, abortion have some of the weakest welfare benefits for women and children, and have higher infant and maternal death rates.
According to a New York Times analysis, the 24 states that have banned abortion (or likely will) do worse on a wide range of outcomes than states where abortion is likely to remain legal, including infant and maternal deaths, teen birth rates and the proportion of women and children who are uninsured. The states likely to ban abortion either have pre-Roe laws that prohibit abortion; have recently passed severe restrictions; or have lawmakers actively considering new bans.
Most of these states have rejected the one-year postpartum extension for Medicaid. Nine have rejected the Medicaid extension of the Affordable Care Act, which provides health care to the poor. None offer new parents paid leave to care for their newborns.
“The safety net is woefully inadequate,” said Carol Burnett, who works with poor and single mothers as executive director of the Mississippi Low Income Childcare Initiative, a non-profit organization. “All of these demonstrated state-level obstacles prevent mothers from getting the help they need, the health care they need, the childcare they need.”
Many anti-abortion activists have acknowledged that improving the health and livelihoods of mothers and young children is an important goal for their movement: “This has been my talk to the pro-life movement for the past year,” said Kristan Hawkins, the president. from Students for life. “No woman stands alone in post-Roe America.”
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But in many of these states there is skepticism about state aid runs so deep as opposition to abortion. And racism has played a role for generations in weakening safety nets for all poor residents, researchers and historians say.
have studies repeatedly found it stating where the safety net is less generous and more difficult to access tend to be those of relatively more black residents. That has further implications for black women, who nationally have a maternal mortality rate close to three times that of white women.
Social spending isn’t the only answer to poverty and poor public health, and some in the anti-abortion movement insist they want to help women and children — just not with more government spending. But there is a strong link between state policy choices and outcomes for mothers and children, researchers have found.
Perhaps the most obvious example is health insurance. numerous studies have linked it to better health and financial security for poor Americans. Since 2014, states have the option to: expand their Medicaid programs to cover nearly all poor adults, with the federal government paying 90 percent or more of the cost. But nine of the states that want to ban abortion have not expanded it, citing: opposition to Obamacare, which Republicans have long vowed to repeal; an aversion to providing health benefits to poor Americans that don’t work; or worry about the 10 percent of the bill left to state governments to finance.
“Closing the Medicaid gap is the first and best option for women’s health care,” said Allison Orris, a senior fellow focused on health policy at the left-wing Center on Budget and Policy Priorities.
Since 2021, states also have the option of extending Medicaid to women for an entire year after a birth instead of two months. Only 16 states have refused to do so or have opted for a shorter period — all but three of which are banning or seeking to ban abortion.
Women who are poor and pregnant are eligible for Medicaid nationwide, and the program pays for four in ten births nationwide. But health experts say it also matters that women are covered for a longer period of time after birth and for the years leading up to pregnancy. Conditions such as diabetes, cardiovascular disease and substance abuse can lead to pregnancy complications and poor child health. Research suggests that Medicaid expansion can: reduce maternal mortality. Medicaid also pays for birth control.
Paid family leave and subsidized childcare are another example. None of the states that have banned (or likely will) abortion guarantee that parents will get paid time off from work to care for and bond with their newborns. Only 11 States and the District of Columbia to do. Paid leave has been shown to benefits infant health and mothers physical and mental health as well as their economic outlook.
In most states, there is no guaranteed childcare for children until they start kindergarten at age 5. Grants available for low-income families cover a small segment of eligible children, ranging from less than 4 percent in Arkansas (which now bans abortion) to more than 17 percent in Vermont (which passed abortion rights legislation).
In many states, subsidies are also a mystery: parents have to work to get them, but they can’t find work or start without childcare. Some states add other obstacles. Mississippi requires single mothers to apply for child support from fathers before they can receive subsidies. Also, a minimum wage job — which doesn’t exceed the federal floor of $7.25 in 20 states — doesn’t necessarily pay enough to cover even subsidized care.
Support for families is different in some states as soon as children are 3 or 4 years old. Thirteen states and the District of Columbia offer or have committed to provide universal early childhood education. Unlike other family benefits, anti-abortion states are about as likely as other states to offer public preschool. Six of those 13 states prohibit or are likely to prohibit abortion.
“This is consistent with the view that education is a public responsibility,” said Steven Barnett, senior co-director of the National Institute for Early Education Research at Rutgers, while other safety net programs “are outside the accepted sphere of public responsibility in conservative states. ”
Poorer states may have fewer resources to fund benefits such as parental leave, or state supplements to the federal tax credit for earned income. But what they choose to do with federal grants can be revealing, said Zachary Parolin, a social policy professor at Bocconi University in Milan who has studied how states use the wide discretion given to them by the welfare program Temporary Assistance for Needy Families. .
“You can’t say Alabama gives very little money to low-income families and children because it can’t afford it,” Mr Parolin said. “It has a TANF program and is primarily funded by the federal government.”
But in 2020 Alabama spent alone about 8 percent of its welfare funds about direct financial assistance to families. Mississippi spent 5 percent. Instead, states often spend these grants on a wide variety of other programs, such as marriage ad campaigns and abstinence-only sex education (in 2020, a state auditor in Mississippi found that the state has misspent millions of federal welfare dollarsincluding speeches never delivered by former quarterback Brett Favre).
Mr Parolin’s research has shown that states with higher black populations tend to spend the least on cash assistance, widening the poverty gap in America between black and white children. The Times analysis also found that states likely to ban abortion spend a smaller share of Social Security on basic aid.
States with less generous safety net programs also often use complex rules and paperwork until further restrict access to benefitssaid Sarah Bruch, a professor of social policy and sociology at the University of Delaware. States could help women and families, she said, not only by investing more in the safety net, but also by making it easier to find and use.
Angela Rachidi, a senior fellow who studies poverty and safety net programs at the right-wing American Enterprise Institute, said government has a role to play, but not only: “We have a broader responsibility as a society — employers, churches, community organizations — to making sure that mothers feel they can bring those children into the world.”
Evidence to date suggests that those organizations will struggle to meet growing need.
After the Supreme Court’s decision, other governors who banned abortion proclaimed their commitment to pregnant women and children. “Being pro-life is more than being pro-birth,” Oklahoma governor J. Kevin Stitt wrote in a statement. executive order signed July 11
Oklahoma ranks among the lowest 10 states in terms of child poverty, infant mortality, and the proportion of women of childbearing age without health insurance.
In Texas, Governor Greg Abbott said in a statement that the state has “prioritized health care support for women and expectant mothers in need.”
He pointed to Texas’s decision to offer moms six months of postpartum Medicaid coverage. But the state declined the full year of coverage offered by the federal government. Texas has also used techniques to take children out of Medicaid coverage for paperwork expires. It has a higher percentage of uninsured children and women of childbearing age than any other state.
In its legislation restricting abortion, Texas has earmarked $100 million over two years for a program that connects women with counseling, education, and supplies called Alternatives to Abortion. That funding pales in comparison to another benefit, which Texas rejected — the an estimated $6 billion in federal funds per year that it loses by choosing not to expand Medicaid.
Josh Katz reporting contributed.