Reproductive Care Crisis: Texas Falls To 49th Place In National Health Ranking

According to a recent health system ranking by The Commonwealth Fund, Texas lags behind nearly all other U.S. states in terms of reproductive care and women’s health.

The Lone Star State placed 49th out of 50 states and the District of Columbia, surpassing only Mississippi and New Mexico in the bottom rankings for women’s health. Overall, Texas ranked 48th when considering all seven broad categories.

Every year, the Commonwealth Fund’s Scorecard on State Health System Performance uses the most recent data to assess how well the healthcare system is working in every U.S. state. The 2023 scorecard is based on 2021 data, which means it does not reflect the impact of abortion restrictions or bans implemented after the fall of Roe vs. Wade in June of the previous year.

Access to usual and preventive care for women of reproductive age significantly contributed to Texas’ low ranking in women’s health. The state ranked last in the percentage of births without early prenatal care in the first trimester, with nearly 30% of women lacking access to timely prenatal care, as reported by The Dallas Morning News.

Texas also had an above-average rate of preterm births, which pose increased risks of complications or death for babies. 

Texas’ high uninsured rate exacerbates these problems. The state consistently ranks last in terms of health insurance coverage. Approximately 12% of Texas children lack insurance, while nearly a quarter of adults are uninsured. Hispanic Texans are even less likely to have coverage, with almost 40% of Hispanic adults lacking insurance.

During the pandemic, health insurance rates in Texas took a toll, more than 65,000 Texans lost their health insurance when they lost their jobs between February and May of 2020, according to a study by the National Center for Coverage Innovation at Families USA, a nonprofit health care advocacy organization.

However, during the COVID-era there were rules preventing Medicaid disenrollment, these protections will disappear in May and the number of insured individuals is expected to decrease by over 1 million.

Researchers have long emphasized the implications of high uninsurance rates, particularly for pregnant women and new mothers. A recent study by UT Southwestern Medical Center found that new mothers experienced better health outcomes when enrolled in Parkland Health’s program, which provides expanded maternal care for up to one year after birth.

The Texas state Legislature approved a bill to extend postpartum Medicaid coverage to a full year for low-income women, with the inclusion of an anti-abortion provision – a policy already implemented in more than 30 states.

The Commonwealth Fund suggests several solutions to address gaps in reproductive and women’s healthcare, including increased investment in maternal health and community health workforces.

Overall, the ranking highlights the pressing need to improve reproductive care and women’s health in Texas, paying attention to equitable access to healthcare services and addressing the specific challenges faced by different populations.