Idaho bans nearly all abortions — and just declined to expand postpartum Medicaid coverage

Courtesy Idaho Capital Sun


Without coverage from Idaho’s Medicaid program, Moscow resident Erin Singer is convinced she would have felt forced to seek an abortion when she got pregnant with her son in 2017.

Erin Singer
 Moscow, Idaho, resident Erin Singer at 30-weeks pregnant with her son, Adam, in 2017. Singer has a rare autoimmune disease that causes abnormal blood clotting and had Medicaid coverage during her pregnancy. (Courtesy of Erin Singer)

And without coverage from Medicaid after she gave birth, Singer wouldn’t have been able to afford the physical therapy required to treat the debilitating pelvic condition she developed during pregnancy.

Singer discovered she was pregnant just a few days before a rheumatologist told her the frequent headaches, aches and pains and the multiple miscarriages she had experienced were likely due to an autoimmune disease that causes abnormal blood clotting. To safely continue her pregnancy, Singer had to take an injectable blood thinner.

Without insurance, the medication can cost between $75 and $250 per month, which Singer said she wouldn’t have been able to afford.

“It’s not just the baby that could have a problem (without it), I could have a stroke. And I had a (2-year-old) daughter to think about,” Singer said.

As of 2020, 42% of women across the United States had Medicaid as their insurance coverage at the time they gave birth. Medicaid is a government health insurance program for people who qualify according to income and certain disabilities, and until recently, most states only allowed continuous Medicaid pregnancy coverage for 60 days after delivery. After that, postpartum individuals are required to submit monthly proof of eligibility. Research has shown that continuity of care following childbirth is associated with better health outcomes for the person who gave birth and the infant.

According to the Centers for Disease Control and Prevention, 1,205 maternal deaths were recorded in 2021 — a nearly 40% increase over the previous year’s number of 861. The year before that, there were 754. Those numbers are thought to be partially attributed to the COVID-19 pandemic, but pre-COVID, the United States still had some of the highest maternal mortality rates of industrialized nations. 

The 2018 rate of 17.4 deaths per 100,000 live births was more than double the next highest rate in France of 8.7 deaths.   

The CDC also notes that for every maternal death, there are about 100 “near misses,” when a person comes close to losing their life during or after a pregnancy.

The federal American Rescue Plan Act allowed states to change the continuous Medicaid coverage to one full year following delivery without applying for a waiver, and as of March 24, all but three states — Idaho, Iowa and Nebraska — have already expanded, intend to expand or have legislation pending that would expand the coverage.

Of the 13 states that have abortion bans in effect, Idaho is the only one that has not expanded coverage.