Alabama lawmakers pass legislation that could give pregnant women more
access to health care
[April 09, 2025]
By SAFIYAH RIDDLE
MONTGOMERY, Ala. (AP) — Alabama legislators unanimously passed a bill on
Tuesday that would expedite access to Medicaid for pregnant women, as
more states across the South attempt to stem high maternal and infant
mortality rates.
The “presumptive eligibility” legislation states that Medicaid will pay
for a pregnant woman’s outpatient medical care for up to 60 days while
an application for the government-funded insurance program is being
considered.
The bill will now go to Republican Gov. Kay Ivey's desk for her
signature.
Many Republican legislators endorsed the bill as “pro-life." Democratic
lawmakers said that it was essential for addressing Alabama's delivery
health outcomes that lag behind the rest of the country.
Other states have adopted a similar strategy for addressing some of the
highest infant and maternal mortality rates nationwide. Legislators in
Mississippi and Arkansas have passed laws that would offer similar
coverage to expectant mothers.
One study found Alabama had a maternal mortality rate of 64.63 deaths
per 100,000 births between 2018 and 2021, nearly double the national
rate of 34.09 per 100,000 births. That jumps to 100.07 deaths for Black
women in the state.
Hospital closures in rural parts of the state have left many women
without access to prenatal care. Last year, nearly 1 in 5 pregnant
Alabama women didn't receive prenatal care until after five months of
pregnancy, or otherwise received less than 50% of the appropriate number
of the recommended visits throughout her pregnancy, according to The
March of Dimes.
That is in part because one in six women of childbearing age fall within
the coverage gap, making too much to qualify for Medicaid but too little
to afford private insurance, according to Alabama Arise, an advocacy
group for low-income families.
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Rep. Marilyn Lands speaks at a press conference in the Alabama
Statehouse, Feb. 14, 2025. Montgomery, Ala. (AP Photo/Safiyah
Riddle)
 Alabama is among 10 states
nationwide that have not expanded Medicaid, which means many
low-income women are only eligible for Medicaid once they become
pregnant.
A pregnant woman in Alabama with no dependents can qualify for
Medicaid if she makes $21,996 or less, or up to $37,704 if she is
part of a household of three.
Medicaid was used to pay for 45% of all births in Alabama in 2023,
according to the most recent report published by the Alabama
Department of Public Health. More than half of all infant deaths
were to mothers who used Medicaid.
The Alabama bill would increase Medicaid spending statewide by about
$1 million annually over the course of three years, with about
two-thirds coming from the federal government.
Another bill that advanced in March seeks to expand access to
medical care for expectant mothers by allowing midwives to provide
care outside of hospitals in freestanding birth centers. But recent
amendments to the legislation prohibits midwifes from performing
many standard medical screenings for newborns that are necessary to
detect genetic disorders.
The Alabama Midwives Alliance said that the legislation “started as
a good bill” in a video posted on Facebook in April, but added that
the amendments “take it in the wrong direction.”
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