Assignment Prompt & Instructions
Florida maintains a mixed regulatory framework in maternal health that combines insured coverage and state assistance programs for uninsured women. However, the state has not expanded Medicaid under the Affordable Care Act, leaving approximately 1.3 million low-income residents without regular access to affordable health care. Health plans, including Medicaid, cover contraceptive methods, including long-acting reversible methods, without copayment under the provisions of the ACA (Neiman et al., 2021). Coverage of fertility treatments varies by insurance plan and is not universally guaranteed. As of May 2024, Florida prohibits abortion after six weeks gestation, with limited exceptions. State law requires informed consent, performance of an ultrasound at least 24 hours prior to the procedure and, for minors under 18, the consent of at least one parent.
Reproductive health clinics funded by the Title X program have faced significant reductions in capacity due to federal policy changes and lack of adequate funding. This has limited access to family planning and reproductive health services for low-income and uninsured women in the state. In 2022, the infant mortality rate in Florida was 6.0 per 1,000 live births, slightly above the national average (Krass et al., 2022). The maternal mortality rate was 24.1 per 100,000 live births, also above the national average. Black women in Florida face significantly higher maternal mortality rates than white women, reflecting inequities in access to and quality of health care. The lack of Medicaid expansion in Florida limits access to preventive services, which can contribute to unplanned pregnancies and undetected complications. Studies show that states that have expanded Medicaid have experienced reductions in maternal and infant mortality rates. To improve these indicators, it would be beneficial for Florida to consider expanding Medicaid and removing barriers to accessing reproductive health services (Diouf et al., 2024).
References
Diouf, F., Thompson, T., Silesky, M., & Bonnevie, E. (2024). A Call to Action: Supporting Black Maternal and Infant Health Using the Collective Impact Model. Maternal and Child Health Journal, 28(8), 1265-1271. https://doi.org/10.1007/s10995-024-03937-z
Krass, P., Tam, V., Min, J., Joslin, I., Khabie, L., Wilkinson, T. A., & Wood, S. M. (2022). Adolescent Access to Federally Funded Clinics Providing Confidential Family Planning Following Changes to Title X Funding Regulations. JAMA Network Open, 5(6), e2217488. https://doi.org/10.1001/jamanetworkopen.2022.17488
Neiman, P. U., Tsai, T. C., Bergmark, R. W., Ibrahim, A., Nathan, H., & Scott, J. W. (2021). The Affordable Care Act at 10 Years: Evaluating the Evidence and Navigating an Uncertain Future. The Journal of Surgical Research, 263, 102-109. https://doi.org/10.1016/j.jss.2020.12.056.
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