The extraordinary danger of being pregnant and uninsured in Texas

Over three years, nearly 400 pregnant or new mothers died in Texas. Its system for helping the uninsured thwarts women at every turn, frustrates doctors and midwives, and incentivizes substandard care.

Texas Tribune | By Nina Martin, ProPublica and Julia Belluz, Vox
December 6, 2019

This story was co-published with ProPublica and Vox.

From 2012 through 2015, at least 382 pregnant women and new mothers died in Texas from causes related to pregnancy and childbirth, according to the most recent data available from the Department of State Health Services; since then, hundreds more have likely perished. While their cases reflect the problems that contribute to maternal mortality across the United States — gross medical errors, deeply entrenched racism, structural deficiencies in how care is delivered — another Texas-size factor often plays a significant role: the state’s vast, and growing, problem with health insurance access.

About one in six Texans — just over 5 million people — had no health insurance last year. That’s almost a sixth of all uninsured Americans, more than the entire population of neighboring Louisiana. After trending lower for several years, the Texas rate has been rising again — to 17.7 percent in 2018, or about twice the national average.

The numbers for women are even worse. Texas has the highest rate of uninsured women of reproductive age in the country; a third were without health coverage in 2018, according to a State Health Services survey. In some counties, mainly along the Mexico border, that estimate approaches 40 percent.

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