Georgia's Women of
Reproductive Age Face Many

Barriers to Health Care

Or eeaces MOY outa
Ps Health Policy Institute

August 2022

 

One in Five Women of Reproductive
Age Is Uninsured in Georgia

Largely due to the state's decision not to expand Medicaid, Georgia has one
of the highest rates of uninsured women of reproductive age (18-44) in the
country with nearly one in five (19.3 percent) lacking health insurance.
Georgia ranks 46th in the country and has the highest uninsured rate for
women in this age group in the deep South apart from Mississippi (Florida
has a similar rate). See Figure 1.

Figure 1. Nearly 1 in 5 Women of Reproductive Age (18-44)
Was Uninsured in Georgia in 2019

 

Source: Georgetown University Center for Children and Families analysis of the U.S. Census
Bureau 2019 American Community Survey (ACS) Public Use Microdata Sample (PUMS).

The Uninsured Rate Is Even Higher for
Latinas and Other Groups

Women in this age range of all races in Georgia face high rates of uninsurance
as compared to the national average (12.8 percent). White and Black women
in Georgia are uninsured at similar rates; both groups are higher than the
national average. Almost half (45.9 percent) of women of reproductive age
who identify as Hispanic or Latina are uninsured in Georgia, and this is
almost twice as high as the national average for Latinas. American Indian/
Alaska Native (35.9 percent) and Multiracial/Other (88.0 percent) women also
have very high uninsured rates. See Figure 2.

Key Findings

e Almost one in five women (19.3 percent)
in Georgia of reproductive age (18-44)
has no health insurance. This is one of
the highest rates in the country (Georgia
ranks 46th) and, even more notably, one
of the highest rates in the deep South-
where only Mississippi has a significantly
higher rate (21.2 percent) of uninsured
women of reproductive age.

e Almost half (45.9 percent) of women
of reproductive age who identify as
Hispanic or Latina are uninsured in
Georgia. American Indian/Alaska Native
(35.9 percent) and Multiracial/Other (38.0
percent) women also have very high
uninsured rates.

e Like the rest of the Unites States, Georgia
has much higher rates of maternal and
infant mortality for Black women and
babies than white women and babies.

e Some of Georgia's maternity care
outcomes are far below the national
median. The state ranks poorly on quality
measures in its Medicaid program such
as access to postpartum care, timeliness
of prenatal care, and the percentage of
babies with low birthweight.

This factsheet was written by Joan Alker,
Aubrianna Osorio, and Leo Cuello.The authors
would like to thank Hannah Klukoff for her
research assistance. Design and layout provided
by Nancy Magill.

The Georgetown University Center for Children
and Families (CCF) is an independent,
nonpartisan policy and research center founded
in 2005 with a mission to expand and improve
high-quality, affordable health coverage for
America's children and families. CCF is based
at the McCourt School of Public Policy's Health
Policy Institute.
Figure 2. Uninsured Rate for Women of Reproductive Age (18-44) in
Georgia and the U.S., by Race and Ethnicity, 2019

| | Georgia U.S.

35.9%
24.0%
18.3% 18.8%
13.3%
9 12.0%
Asian/Native Black/African White* American
Hawaiian/Pacific American® Indian/Alaska
Islander* Native

45.9%
38.0%
24.3%
20.7%

16.2%

, 9.8%
Multiracial/ Not Hispanic/ Hispanic/

Other* Latina* Latina*

Source: Georgetown University Center for Children and Families analysis of the U.S. Census Bureau 2019 American Community Survey (ACS) Public Use

Microdata Sample (PUMS).

* Difference is significant at the 90 percent confidence level compared to the U.S.

Poor Health Outcomes and Disparities for Georgia Mothers and Babies

The United States has a very high rate of maternal mortality
(23.8 per 100,000 live births) compared to many of its peer
nations, and Georgia's rate (24.5) is slightly higher than the
overall U.S. rate for the most recent year of data available
(2020). Black women face much higher rates of maternal
death (40.9) in Georgia as is the case elsewhere. Infant
mortality presents similarly with Georgia babies dying at a
rate of 6.1 per 1,000 live births, slightly higher than the U.S.
average (5.2). Black babies die at higher rates (8.9) in Georgia
than white babies (5.0) though this is lower than the national
rate for Black babies (10.2).

 

Georgia's Medicaid program is performing poorly on some key
maternal and infant health metrics as compared to other states
such as the timeliness of prenatal care, access to postpartum
care, and the percentage of babies who have low birthweight.
Georgia is in or near the bottom quarter of all states that report
each of these metrics. Sixty seven percent of Georgia babies
are receiving all of their recommended well-child visits within

the first 15 months of life, just over the national median of 66
percent in Medicaid and CHIP.

Although Georgia's Medicaid program is performing poorly

in most maternal and infant health metrics, these metrics

look only at those women who are able to access Medicaid

or CHIP as a parent or while pregnant. Many other women
have no coverage at all as described above. These women

are largely excluded because the state has not expanded
Medicaid to adults as described above. This problem is
compounded by the fact that Georgia's Medicaid eligibility limit
for parents is extremely low. A mother with two children would
be over the income limit if she earns just $634 a month. Ina
positive development, the state has adopted the new option to
increase postpartum Medicaid coverage to 12 months."

* The postpartum option is not in effect yet because currently everyone
who gave birth while receiving Medicaid since March of 2020 is retaining
their coverage anyway due to the continuous coverage provisions
associated with the COVID-19 public health emergency.

Table 1. Georgia Reporting on Select Maternity Core Set Measures, FFY 2020

 

Maternity Core [€T-Yo) ge |= ks pS} rc) Ao e=i§ Median siotoie
Set Measure Rate Ranking State Rate State Rate
Timeliness of prenatal care 77.6% 30 (40 states reporting) 27.4% 84.4% 95.6%
Postpartum care 63.0% 32 (39 states reporting) 20.7% 72.3% 91.6%
Percentage of low weight live births under 12.1% 48 (52 states reporting) 14.3% 9.7% 74%
2,500 grams (lower rate is better)

Well-child visits in the first 15 months of life 66.9% 21 (50 states reporting) 5.9% 65.6% 87.2%

 

Source: Georgetown University Center for Children and Families analysis of Centers for Medicare & Medicaid Services Child Health Quality Measures
Dataset, FFY 2020, available at ok :

 

AUGUST 2022 CCF.GEORGETOWN.EDU GEORGIA'S WOMEN OF REPRODUCTIVE AGE FACE BARRIERS IN HEALTH CARE