Volume 20
Issue
1
Date
2018

Medicaid Approaches to Addressing Maternal Mortality in the District of Columbia

by Tara Wilson

Maternal mortality in Washington, DC, has reached crisis levels. In a country that boasts the highest maternal mortality rate (MMR) in the developed world, DC’s MMR is double the national MMR. The closure of obstetrics units in areas of concentrated poverty has made the problem particularly acute in low-income DC communities, and most low-income residents in DC are black. This paper aims to present changes in Medicaid policy that DC City Council may take to prevent further reductions to access to obstetric care and to pro-mote healthy pregnancies. In Part II, this paper will address contributing factors to DC’s maternal health crisis, and in Part III, the paper will argue for: (1) increased base payment reimbursement for obstetric services, (2) expanded public transportation to improve access to those hospitals with obstetrics units, and (3) the extension of Medicaid coverage to doula services to improve financial feasibility for hospitals and ensure healthy pregnancies for patients. Finally, Part IV addresses the advocacy required to implement these changes.

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