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Report: Nearly 25% of rural pregnant women in MN rely on Medicaid

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As Congress weighs enacting Medicaid reforms to reduce spending, the research community has new findings looking at how the public health insurance program props up maternal care in rural communities.

Minnesota is in the top half of states when linking Medicaid coverage with needs for maternal care in rural areas.

That's according to a new report from the Center for Children and Families at Georgetown University.

In rural Minnesota, more than 23% of women of childbearing age are covered by Medicaid. That's in line with the national average and 4% higher than the state's metro counties.

University of Minnesota Professor in the School of Public Health, Dr. Katy Kozhimannil, is part of the broader research community looking at this issue.

She said these numbers come amid a continued decline of obstetric care in these communities.

"More than a decade into a maternal health crisis in this country," Kozhimannil said. "Fewer and fewer U.S. hospitals provide obstetrics every year with rural hospitals experiencing the greatest losses."

Researchers say this care is expensive, and big Medicaid adjustments create more harm for rural providers, putting the health of mothers and babies at risk.

House Republicans are considering program reforms, including work requirements, to help pay for tax cuts.

The GOP says streamlining services keeps the program strong for vulnerable people, but the Congressional Budget Office estimates nearly 8 million people would lose coverage.

With that CBO forecast, Democrats and health advocates contend the proposed changes amount to massive cuts.

The Georgetown Center's Executive Director and Co-founder Joan Alker said the current debate over Medicaid is one of the more consequential ones she has seen in her time tracking federal policy.

"And the reality is that these cuts," said Alker, "could be extremely pernicious and dangerous for rural communities."

The report says in 2023, Medicaid covered 41% of births nationwide, but nearly half of all births in rural areas.

As for the chance of increased health risks, these researchers note that rates of infants with low birth weight in rural counties tend to be higher than those in urban settings.