JEFFERSON CITY, Mo. – Missouri's record in insuring women of childbearing age is worse than the national average, according to a new report.

Researchers found that 13.9% of Missouri women ages 18 to 44 are uninsured, compared with a nationwide average of 12.3%.

Executive Director Joan Alker at the Georgetown University Center for Children and Families, blames Republican hard-liners in the state legislature for blocking any expansion of Medicaid under the Affordable Care Act.

"The more pragmatic elements of the party want to do it; they understand the budget value of having these folks covered and bringing in the federal dollars," Alker explained. "But there remains really sharp ideological resistance, I think, to embracing the Affordable Care Act. So, this is going to continue to be a live issue going forward."

The report showed states that expanded Medicaid have seen a 50% greater reduction in infant mortality and fewer women dying in childbirth, compared with non-expansion states such as Missouri.

Right now, Missouri adults can only get Medicaid if they are basically destitute, with a monthly income of less than $373 for a family of three. The program does cover expectant mothers once the pregnancy is confirmed by a doctor – but that coverage ends 60 days after the child is born.

Pediatrician Dr. Ken Haller, who serves on the board of the Missouri Chapter of the American Academy of Pediatrics, says that causes major disruptions in care, which hurts children and mothers alike.

"If their health isn't being attended to, they can't be as good a parent to their child as they would like," said Haller. "And we all need for those children to grow up in a healthy, happy way."

Kendra Copanas, executive director of the nonprofit Generate Health/a>, said the report shows the major racial disparity in birth outcomes for African-Americans in St. Louis.

"Black infant mortality is at three-and-a-half times the rate of white infants," she stressed, "and that gap is bigger than it was 10 and 50 years ago."

About a year ago, the Missouri Legislature voted to extend Medicaid coverage for 12 months postpartum for women with substance-use disorders only. However, the state has not yet implemented the policy.

The Georgetown report was released in conjunction with the March of Dimes and the American College of Obstetricians and Gynecologists.

Women in California and across the country earn an average of 82% of what men make in the first 10 years after graduating from college, according to a new study from the National Association of Colleges and Employers.

Researchers found that a significant portion of this disparity is attributed to where people work - three-quarters of men are employed in the private sector, compared to only half of women.

Mary Gatta is the director of research and public policy at NACE.

"The top industries where men were employed were manufacturing, finance, insurance, real estate, the fire industries, architecture, and engineering," said Gatta. "Women are in education, health care, social assistance, and professional and technical services. So women dominate more in lower-paid industries."

Advocates say school districts should introduce boys and girls to all types of occupations, and in particular, encourage girls to take classes in science, technology, engineering, and math.

California has tried to shrink the pay gap through public policy. Companies in the Golden State are prohibited from inquiring about a candidate's previous salary range during the hiring process.

They are also required to disclose salary ranges in job postings or upon request.

Gatta said colleges should offer robust career counseling to prepare students as they enter the workforce.

"We also need to think about salary negotiation," said Gatta, "and helping remove any concerns that recent college grads might have about negotiating, helping prepare students for salary negotiation."

She added that establishing a higher salary from the get-go pays dividends for many years.

Conversely, the pay gap persists as women progress in their careers, so they contribute less to Social Security and receive lower payments in retirement.

Support for this reporting was provided by Lumina Foundation.




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Texas lawmakers passed the Life of the Mother Act during the legislative session. It was billed as legislation to clarify when doctors in the state can legally perform an abortion.

Texas adopted one of the most restrictive abortion bans in 2021. The ban allows the procedure only if the life of the mother is in danger or there is a risk of impairment of a primary bodily function.

Houston-based OB/GYN Dr. Damla Karsan said, despite the "clarification," medical professionals are still hesitant to provide care in most cases.

"It's been frustrating, because I feel restricted in my ability to offer them the full scope of options for their care," said Karsan. "I know it's really had a chilling effect on all my colleagues, and myself as well."

Karsan was involved in two legal challenges to the abortion ban, including the case of Kate Cox.

The Houston mother of two received national attention after traveling to another state to have an abortion after it was determined her third child would not survive.

Backers of the new legislation say it ensures women who have medical emergencies can get an abortion.

It defines "life-threatening" as a condition that's capable of causing death or serious injury. A survey of OB/GYNs in the state shows 60% of those who responded fear legal repercussions.

Karsan said if women need abortion care, there are organizations available to help.

"I direct a lot of people to the National Network of Abortion Funds," said Karsan. "Their website can connect you if you want to donate, if you want to volunteer, but also if you're looking for care. As usual it's the poor, the disenfranchised that are going to suffer the most."

According to the survey, many doctors are leaving the state or going into early retirement because of the abortion ban.




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Fighting for a wide range of people with a skill for compromise, is how Rep. Melissa Hortman, D-Brooklyn Park, is being remembered for following her assassination Saturday.

A civic engagement group said she was a shining example of a woman in politics. Hortman's murder is seen by political observers as a stunning and tragic example of the increasingly violent tone surrounding public office in America. Hortman served as Minnesota House Speaker from 2019 until earlier this year, leading Democrats during power-sharing negotiations with Republicans in an evenly-divided chamber.

Michelle Witte, executive director of the League of Women Voters of Minnesota, said Hortman stayed true to the mission of an elected official.

"Obviously, (a) rise to power but also just being in the community working at all levels, at the local level to engage people in issues that are important to them," Witte recounted.

Witte noted Hortman's willingness to make tough decisions was on display this spring when finalizing a new budget, as she received pushback from her own party during the negotiations. Witte pointed out Minnesota still has gaps in electing women legislators, despite having more female politicians than over half the states in the U.S.

She added Hortman was among the most notable women in politics statewide, with others including Sen. Amy Klobuchar, D-Minn., and Sen. Tina Smith, D-Minn.

In 2023, Hortman was credited for spearheading several major policies including paid medical leave, abortion protections, and a universal school meal program. While this year's power-sharing agreement with Republicans did have moments of friction, Witte said Hortman's arrangement with GOP House Speaker Lisa Demuth was symbolic of women succeeding in the world of politics.

"The League of Women Voters, we actually made a card out of the great handshake between Melissa Hortman and Lisa Demuth when they reach their power-sharing agreement," Witte recalled. "I was so proud of that because that is what we really work for at the League, is seeing that working together."

Witte hopes voters pay more attention to those examples of bipartisanship and appreciate elected leaders who go above and beyond to serve the public. She acknowledged the attacks on Minnesota lawmakers may make people feel anxious about taking part in democracy, adding the country needs to promote voter safety and prevent future candidates from being silenced.


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