Roughly 40% of rural births are covered under Medicaid. That’s according to a new study from the McCourt School of Public Policy’s Center for Children and Families at Georgetown University. Senior fellow Elisabeth Wright Burak says nearly 1-in-4 women in rural Arkansas are covered by Medicaid.
As the KUAF Public Radio program Ozarks at Large reports, Wright Burak explained, “In Arkansas, like it is in Most states, you have women that might be in the expansion category of low-income folks, Arkansas Works. But when you get pregnant eligibility actually goes to a higher income level. And so more women actually might qualify for Medicaid once they get pregnant. And that’s why you see the higher rate of births paid by Medicaid in general, but specifically in rural areas as well.”
In February, Congress approved a resolution to cut more than $72 billion in Medicaid funding, which covers 72 million people. Estimates reveal that Arkansas could lose nearly $763 million in federal funds if the cuts are approved. Wright Burak concludes that rural hospitals will be hit the hardest. More than 300 rural hospitals are at immediate risk of closing due to the severity of their financial problems, according to the nonprofit Center For Healthcare Quality & Payment Reform, including 10 in Arkansas.
More rural hospital closures would likely exacerbate the existing health disparities rural women and infants experience. As the graph below illustrates, according to the Pregnancy Mortality Surveillance System from the Centers for Disease Control and Prevention (CDC), risks of pregnancy-related mortality are highest for rural populations.
Wright Burak and her team say their research findings also reveal the vital role that Medicaid plays in reducing disparities in maternal and infant health outcomes. She points to the fact, according to national birth data from the CDC, that more than two-thirds (64%) of black mothers and more than half (58%) of Hispanic mothers had Medicaid coverage reported on birth certificates in 2021.
Yet Arkansas has one of the country’s highest maternal mortality rates and third highest infant mortality rate. And despite renewed efforts in the 2025 legislative session, Arkansas remains the only state that has taken no action to adopt the federal option of extending postpartum Medicaid coverage from 60 days to 12 months after birth, according to KFF.
