Nearly one in five people in the U.S. — or around 59 million people — use at least one type of social safety net programs like the Supplemental Nutrition Assistance Program and Medicaid in the average month, according to a 2019 Urban Institute study. Although non-Hispanic Black people are more likely to participate in one of those programs, the largest share of total participants is white.
Louisiana has the most births on Medicaid in the nation. The state, however, is the outlier in the Gulf South, choosing to expand Medicaid in 2016 under Democratic Gov. John Bel Edwards — allowing more women in general to access care. The state also has plans to extend postpartum Medicaid coverage to a full year for women who might not be covered under that expansion.
Meanwhile, women in Mississippi and Alabama are among the top five states for Medicaid use among pregnant women. Half of all births in Alabama are financed by Medicaid. In Mississippi, that number jumps to 60% of all births. Between 2008 and 2012 in Mississippi, 87% of Black women giving birth and 53% of white women giving birth were insured by Medicaid.
One significant difference, Welchlin says, is the postpartum outcomes.
“Of course, If there were more white women and white babies dying, there would be more of an effort. But we don’t see that,” Welchlin said.
Her office sits directly down the road from the State Capitol. She remembers watching her mother struggle to make ends meet as she only earned a couple of dollars an hour in janitorial work there. Her mother couldn’t afford childcare, so Welchlin used to wait for her to get off work in a utility closet.
Like most other advocates who thought the Medicaid legislation was destined for the governor’s desk, Welchlin was also dismayed by its downfall.
“I’ve lived the struggle and I know what those safety nets do to save lives,” Welchlin said.
For now, advocates will continue to fight for postpartum Medicaid to save women’s lives. The next step to make it happen, Welchlin said, is for white women to stand with them.
“What we need are white women to stand up with us, even more, to say this is important,” Welchlin said. “Philip Gunn needs to be concerned, not just with white lives, but also with Black lives, Latina lives, Asian indigenous women lives. It's about all of us because we make up all Mississippians.”
In the meantime, mothers like Batteast aren’t waiting around to see more mothers die.
She started a non-profit to support women during and after their births called Pickles and Popsicles — named after her favorite pregnancy cravings. Batteast said she knows that support from leadership may not come, so it’s important for women to be advocates among themselves.
“I had to kind of create my own little village of support,” Batteast said. “I want it to be that village for someone else.”
This story is part of The Holdouts, a reporting collaborative focused on the 12 states that have yet to expand Medicaid, which the Affordable Care Act authorized in 2010. The collaborative is a project of Public Health Watch.
This story was produced by the Gulf States Newsroom, a collaboration among Mississippi Public Broadcasting, WBHM in Alabama and WWNO and WRKF in Louisiana and NPR. Support for health equity coverage comes from the Commonwealth Fund.