Sherman Smith
Kansas Reflector

TOPEKA — More Kansans will die during pregnancy and childbirth as a result of proposed federal cuts to Medicaid, says the leader of a state organization focused on maternal health equity.

A new analysis of cuts contained in the GOP’s “big beautiful bill” under consideration by Congress shows that 13,000 Kansans would lose enrollment in Medicaid, and the state would lose $3.77 billion in federal funding.

Sapphire Garcia, executive director and founder of the Kansas Birth Justice Society, said the gutting of Medicaid funding would decimate perinatal care systems and accelerate maternal mortality. The burden, she said, would fall hardest on those who already face steep inequities — Black, Indigenous, rural and low-income Kansans.

Advocates “on the front lines of this crisis” already are exhausted, she said.

“We are tired of fighting a system that continues to ignore our pleas while our communities are left grieving unbearable losses,” Garcia said. “We hold space for families who have buried their babies, their partners, their birthing people — and then we’re asked to carry on as if that grief is not the result of policy choices. But it is.”

Garcia’s comments followed a panel discussion June 12 organized by the United Methodist Health Ministry Fund. The discussion centered on a recent report on access to maternal health care in Kansas and an analysis by Manatt Health of proposed federal cuts to Medicaid.

The report on maternity care access, which was produced by the Kansas Center for Rural Health with funding from the United Methodist Health Ministry Fund, found that most Kansans don’t have local access to inpatient maternity care. Most Kansas counties don’t even have an OB-GYN, and only eight counties have more than five OB-GYNs, the report found.

One of the panelists, Beth Oller, family medicine physician at Rooks County Health Center, said it is difficult to get physicians to move to rural areas, where they might have to cover the ER and provide hospice care and other services to support an undeserved community. And most family doctors who graduate residency don’t have an interest in providing obstetric care, she said.

For a while, she said, she was one of two OB-GYNs at her health center, and the other wasn’t trained for operative deliveries. She spent two years never being off of work because she needed to be available for caesarean sections. Then, the other doctor moved out of state and she couldn’t recruit another physician.

As a mother of four, she said, she was “missing so many things.”

“I was heartbroken when I realized that our maternity unit was going to close,” Oller said. “However, I couldn’t do it anymore alone. I knew it wasn’t feasible to keep going that way.”

She said the closest place to Stockton, where she lives, to deliver a baby now is in Hays, about 45 minutes away. Another doctor travels two hours from Salina to provide some prenatal care, she said.

Panelists during a June 12 discussion said access to maternal care is connected to Medicaid, which finances more than 40 percent of births in the state.

The state’s failure to expand Medicaid to serve more low-income families or allocate adequate reimbursement rates for Medicaid services are factors in maternal health deserts and the financial struggles of rural hospitals, they said. GOP leaders in the Legislature for more than a decade have blocked Medicaid expansion, which would have served about 150,000 adults and children and unlocked nearly a billion dollars in annual federal funding. Kansas is one of 10 holdout states that have not expanded the program.

“We need to remember that economics are policy, and policy is a matter of life and death,” Garcia said during the panel discussion. “The fact that we have not expanded Medicaid has killed birthing people in our state is going to continue to kill birthing people in our state and lead to these poor health outcomes. We need to acknowledge that this is a structural failure of our maternal and health care systems.”

A study published in 2020 by the medical journal Women’s Health Issues found that Medicaid expansion resulted in seven fewer maternal deaths per 100,000 live births.

Garcia told Kansas Reflector after the panel discussion that Medicaid expansion is a necessary step toward racial and reproductive justice. But now, she said, the most urgent concern is to protect Medicaid itself.

“If the federal program is slashed, expansion in Kansas becomes meaningless — there will be nothing left to expand,” she said. “Saving Medicaid must be our top priority, and we also cannot lose sight of the need to expand coverage here in Kansas, where families are still denied basic care due to arbitrary income thresholds and political inaction.”