How Medicaid Cuts Affect Maternal Health

June 09, 2025

The tug of war between potential cost savings via cuts and preserving Medicaid reveal ramifications to maternal health.

A new report by The Commonwealth Fund finds that cuts would erode maternal health access, quality, and equity and leave providers at risk of closure. The report indicates that, the variable state-by-state approach to the unwinding of pandemic-era Medicaid coverage has left millions of women either newly uninsured or with significant gaps in their coverage. A recent survey found that 95 percent of community health centers, which care for 40 percent of low-income women nationwide—almost half of whom are covered by Medicaid—reported having patients who were disenrolled.

Here are a few key takeaways:

• Shouldering the burden:  Medicaid is the main source of coverage and largest single payer for pregnant women’s health care nationwide. In Pennsylvania, nearly 3 million children and adults are enrolled in Medicaid.

• Hospitals depend on Medicaid payments to keep their doors open and maintain access to care for all patients. Statewide, about 13 percent of hospitals’ entire net patient revenue comes from Medicaid, on average.

• Measurable health benefits:  Medicaid beneficiaries use prenatal care during pregnancy more than their uninsured counterparts do and have better health outcomes.

• Expanded access improves health, saves lives:  Medicaid has expanded access to health coverage for women of all ages. Historically, low-income women lacked access to health insurance through their employers and to Medicaid coverage outside of pregnancy, leaving many uninsured. As states have adopted Medicaid expansion, these gaps have narrowed, all-cause mortality has decreased, and women’s health outcomes have improved.   

• In Pennsylvania, Medicaid covers 35 percent of births.

• Collaborating with purpose:  This year, HAP’s Task Force on Maternal and Child Health developed an action plan with guiding initiatives that support hospitals in providing high-quality, equitable, and accessible maternal health care.
• Rural communities rely on Medicaid:  Medicaid helps sustain access in rural areas and protects against health care shortages. Medicaid funding plays a critical role in the financial viability of rural hospitals, community clinics, and other health care systems, and pays most of the bills.
  • About half of Pennsylvania's rural hospitals—which often care for a greater percentage of patients with Medicaid coverage—are operating at a loss, largely because payments do not reflect the actual cost of providing care. On average, rural Pennsylvania hospitals are reimbursed 74 cents for every dollar they spend caring for patients covered by Medicaid. Reducing payments even further or increasing uncompensated care will force more rural hospitals to reduce services or, in the worst cases, close.

Read the report and learn more about HAP’s work to improve maternal health outcomes online.