Who Benefits from Closing the Health
Insurance Gap? Women and Children
More than 40% of the working age uninsured are women and 10% are parents.*
The current Medicaid program in South Carolina covers pregnant women, women up to 12 months postpartum, and children with higher income eligibility than other adults. Research comparing states that have expanded Medicaid to include all working-aged adults with those that have not shows that closing the gap leads to further improvements in maternal, infant, and child health.
The research supports common sense – entering a pregnancy in better health should result in improved birth outcomes, and healthy parents are more likely to ensure better health for their children.
*Source: Kaiser Family Foundation, How Many Uninsured Are in the Coverage Gap and How Many Could Be Eligible if All States Adopted Medicaid Expansion? February 25, 2025
South Carolina’s Health Care Challenges
Current Maternal Health
SC has the 8th worst maternal mortality rate in the US. The Maternal death rate for black SC women is 2.5x higher than that for white women.
Sources: CDC Maternal Mortality 2018 – 2022
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The Impact of Closing the Gap
17% fewer maternal hospital admissions post delivery within 60 days
Source: Health Affairs, Medicaid Expansion Led to Reductions in Post-Partum Hospitalizations, January 2023
Seven (7) fewer maternal deaths per 1000 live births (about 20% decrease); impact was concentrated among black mothers.
Source: Womens Health Issues Journal, Adoption of Medicaid Expansion is Associated with Lower Maternal Mortality, January 2020
“Because the United States is the only wealthy country that does not guarantee health coverage, many patients come into pregnancy with chronic medical conditions that have not been diagnosed or managed before pregnancy, including hypertension, diabetes and heart conditions. Among the leading causes of pregnancy related deaths from 2017-2019 are cardiovascular conditions.”
Source: Dr. Veronica Gillispie-Bell, OBGYN and Associate Professor Ochsner Health, in NYT, 7/16/23
Current Infant Health
South Carolina ranked the 5th worst in the United States in Infant Mortality in 2021 and the 13th worst in 2022.
Source: CDC National Center for Health Statistics 2021 and 2022
South Carolina ranked 5th worst in the incidence of low birthweight and 8th worst in pre-term births.
Source: CDC National Center for Health Statistics 2022
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The Impact of Closing the Gap
Significantly narrowed disparity between black and white mothers in incidence of low birth weight and pre-term births.
Source: Journal of American Medical Association, Medicaid Expansion and Birth Outcomes, January 2019
Pregnancy related hypertension is associated with poor maternal and child health outcomes. Diagnosis of hypertension due to pregnancy increased and incidence of low birthweight infants decreased
significantly in expansion states.
Source: Circulation: Cardiovascular Quality and Outcomes, Association of State Medicaid Expansion Status with Hypertensive Disorders and Singleton First Live Births, January 2022
Current Child Health
South Carolina still has 54,000 children under 18 uninsured
Source: Milken Institute School of Public Health at George Washington University, February 2024 report based on 2022 data for Cover SC
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The Impact of Closing the Gap
Based on experience of other expansion states with a “welcome mat” effect, the Milken Institute of Public Health at George Washington projects that 37,000 additional children would have health insurance coverage with Medicaid expansion.
Closing the gap in Louisiana compared to Mississippi and Texas with gap increased the likelihood of one annual well-child visit by 26 percentage points.
Source: Medical Care, The Impact of Medicaid Expansion for Adults Under the Affordable Care Act on Preventive Care for Children: Evidence from the Southern United States, November 2020
Child Care Workers
Uninsured workers in elementary and secondary schools and child care make it difficult to attract a high quality and stable work force.
Source: Kaiser Family Foundation, Understanding the Intersection of Medicaid and Work: An Update Technical Appendix Table 6, February 2025
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The Impact of Closing the Gap
Child care workers and those working
in schools make up a significant portion of working people who benefit by
gaining insurance coverage with Medicaid expansion.
Source: Kaiser Family Foundation, Understanding the Intersection of Medicaid and Work: An Update Technical Appendix Table 6, February 2025
Interested in getting involved with Cover SC and closing the Coverage Gap?