by Dr. Sarah Verbiest 
Honestly, it isn’t every day that I read a policy brief and experience the range of emotions that I did upon reviewing the new report from Adam Searing and Donna Cohen Ross at the Georgetown Center for Children and Families. “Medicaid Expansion Fills Gaps in Maternal Health Coverage Leading to Healthier Mothers and Babies” may not sound revolutionary, but the findings were pivotal for the field I’ve worked in for over two decades.
At UNC’s Jordan Institute for Families, I have had the opportunity to collaborate with innovative, talented, and dedicated leaders. We have one goal in mind: to bring the best evidence and strategies to North Carolina to prevent maternal and infant death and sickness. As a result, North Carolina is nationally recognized as a trend-setter in maternal and child health.
We were among the first states to have a preconception health campaign, we led on the promotion of treatment to prevent recurring preterm birth, we had one of the early perinatal quality collaboratives, and our Baby Love Program (now Pregnancy Medical Home) is well known for providing care coordination to high-risk mothers. Whether accessing federal dollars to build our infrastructure for treating maternal depression and support community work through Healthy Start, studying regionalization of care, launching a maternal mortality review committee, and creating learning communities around racism, North Carolina has always brought it’s “A” game to this life-saving task.
Yet as hard as we work to maximize limited resources and build new partnerships, we continue to tread water while the current of growing racial inequities pushes us back. To be clear, this is very frustrating. And it’s tragic. Babies and mothers still die at a higher rate in the US than in any other developed nation. Black families suffer at three times the rate white families do in North Carolina.
So, when I read that “State Medicaid expansions have helped to reduce the rates of both maternal deaths and infant mortality…
“…women are getting better health coverage before pregnancy, leading to improved prenatal nutrition and prenatal care.
“And postpartum coverage has improved for women, helping them get the care they need following the birth of their child.” I had a moment.
When I read that, “Medicaid coverage is also a critical piece of the puzzle in reducing racial inequities in affordable coverage and care,” I took a pause.
Finally, when I learned that “Medicaid expansion states saw a greater than 50% reduction in infant mortality compared to non-expansion states,” I had some heart palpitations.
We know that clinical care is just one piece of the puzzle that creates health equity and well-being. This report underscores the impact this policy could have in North Carolina in supporting healthier young adults and families – opening the door to services to help them live their best, most productive lives.
Access to quality health care as conferred by Medicaid expansion has been proven to be a win for mothers, babies, families, and the economy. While programs and research are essential to the equation, until policies shift, we are going to be pushing boulders uphill. And push we will, because Maternal & Child Health leaders always do whatever is in our power for North Carolina’s mothers and babies.
If I could wave a magic wand and get our state’s leaders from across party lines to sit down together for a conversation, I would. Policy makers have the opportunity to open the gate for North Carolina to be one of the best places in the country to be born. This report offers a call to action to go ahead and make it happen! Our mothers and babies deserve it.
Sarah Verbiest, DrPH, MSW, MPH is the Director of the Jordan Institute for Families, UNC School of Social Work, and Executive Director, Center for Maternal and Infant Health, UNC School of Medicine