The debate surrounding abortion often turns on emotional and moral issues, but a Michigan-based policy institute says the economic impact of overturning Roe v. Wade affects the largest number of women.

Ahead of this week's vote on Proposal 3 to restore access to abortion, a Michigan League for Public Policy study reports that losing access to reproductive rights would profoundly affect the economic security of individual women, their families, and their communities.

Anne Kuhnen, a policy analyst with the League and author of the report, said abortion rights affect more than just a few women.

"In Michigan, one in six pregnancies ends in an abortion," said Kuhnen, "which really highlights why this issue is so important because this is clearly health care that pregnant people need and are relying on."

Proposal 3 would block the implementation of a 1931 Michigan law - still on the books - that makes most abortions a felony. Opponents claim the referendum would repeal current parental consent laws and allow minors to go through gender-reaffirming treatments without their parent's consent.

Kuhnen said her research shows that a loss of access to abortion care would have an outsized effect on marginalized communities.

"Black and Latino women especially are over-represented in some of the lowest-paying fields, like child care, low-wage health care jobs," said Kuhnen. "So, the negative effects of being unable to access these essential health-care services are really amplified for women of color."

Kuhnen said the social and economic well-being of children is directly linked to a mother's economic status.

Research shows children of women denied abortions are more likely to grow up in poverty and more likely to experience poor maternal bonding, which can affect social and cognitive development.

"The vast majority of Michiganders are paying out of pocket for their abortion," said Kuhnen. "And for someone who's earning minimum wage in Michigan, that's basically your entire paycheck for two weeks."

New mothers in Wyoming enrolled in the Medicaid Pregnant Women Program lose their health insurance 60 days after giving birth, but a new bill making its way through the state's 67th Legislature would extend coverage for a full year.

Marissa Carpio, policy associate for the Wyoming Women's Foundation, said having health insurance is the number one determinant of good health, for mothers and newborns.

"Having health insurance means that you're more likely to seek preventive care, or get that odd symptom checked out that maybe arose during birth or after birth," Carpio observed. "And to not have to sacrifice the funds for your food or your rent to go figure out those health complications."

House Bill 4, sponsored by the Joint Labor, Health and Social Services Interim Committee, is now on General File and could get its first vote today.

Some critics have argued expanding coverage for new mothers is unnecessary because assistance is already available through Medicaid's Family Planning program. Newborns remain eligible for health insurance during their first year.

Carpio pointed out the family planning program is not comprehensive, it only covers gynecological exams and lab tests. It does not cover health issues including heart disease or stroke, which are leading causes of death for new mothers.

Working women of childbearing age are currently the largest group in Wyoming without insurance, largely because they are less likely to get coverage through their employer.

"They're more likely to be working part-time, low-paying jobs that don't offer insurance anyway," Carpio noted. "This type of program that is so specific to new mothers in our state is very important for the success of babies and communities."

According to the Wyoming Department of Health, nearly one in five new mothers participating in the Medicaid Pregnant Women Program currently end up losing health insurance.

Carpio believes healing after birth is a long and important process, and access to care will help women avoid financial and health-related stress, return to work and attain economic self-sufficiency.

"The biggest and most important thing is that continuous coverage after birth," Carpio emphasized. "When you're trying to raise a newborn child, trying to get back to work, the last thing you want to do is try to get your health insurance back to go see the doctor. You should be able to see the doctor when your family needs to."

Wyoming has managed to buck a national trend which has seen female students opting out of college at more than twice the rate of males since 2020.

Ben Moritz, deputy director of the Wyoming Community College Commission, said the percentage of women attending community college has been consistently on the rise, even during the pandemic. He believes one reason more women were able to continue their education is because the state took swift action to provide child care grants to student parents.

"Hundreds of students across the state were able to take advantage of this," Moritz explained. "Disproportionately female students, who perhaps otherwise would have had to drop out of school because they couldn't afford the child care while they were in class."

Federal CARES Act dollars were directed to Wyoming's Department of Family Services, which then partnered with community colleges to distribute child care grants. The state also directed funds to colleges to provide scholarships to students in financial need resulting from the pandemic.

Women are more likely to drop out to take care of children, parents or family members with health problems, according to the National Student Clearinghouse Research Center report, and many do not return to complete a certificate or degree.

Moritz pointed out women who do stop out are at much greater risk of facing long-term economic disadvantages than men who can stay in school.

"There's a lot of statistics that show that a student who starts a program but does not finish it," Moritz noted. "The difference between a student who starts a program and actually finishes the program -- as far as the wage earnings they get -- is significant."

Overall enrollment in community colleges and four-year institutions has been on the decline in Wyoming and across the nation during the pandemic, but Moritz emphasized Wyoming's falloff has not been as severe as other states.

He added Wyoming's decentralized, independently managed community colleges and universities have been able to react quickly to the needs of communities.

"Wyoming, as the smallest state in the union by population, is well positioned to pivot quickly," Moritz argued. "If you're turning an ocean liner around, they can't turn on a dime because they're so big. A smaller boat can turn a little bit quicker."

Support for this reporting was provided by Lumina Foundation.

Minnesota lawmakers are back at work for a new legislative session, and changes approved last year are now being implemented, including efforts to ensure new mothers get the health care they need.

Last Sunday, a new law expanded postnatal care by requiring public and private health plans to cover a series of care visits for up to 12 weeks after a baby is delivered. Two of those visits would have to involve comprehensive care.

Rep. Ruth Richardson, DFL-Mendota Heights, was the bill's sponsor and hopes it helps address the maternal mortality crisis.

"What we know about these deaths is that 80% of them are preventable," Richardson emphasized. "This is a step in the right direction to ensure that when people are in need of support that they can get it."

The U.S. has the highest maternal mortality rate among developed countries. In states such as Minnesota, the rates are higher for women of color.

A recent state health department report noted Black Minnesotans represent 13% of the birthing population but make up 23% of pregnancy-associated deaths. The disparities also exist within the infant mortality rate.

Richardson argued by expanding access to coverage in the weeks after the delivery date, there's hope for a better outcome for both the mother and child.

"It's part of that comprehensive visit," Richardson explained. "It will include things related to the infant's care; their feeding and other things as well."

Richardson acknowledged there is more work to do to close existing gaps. She pointed out another solution should involve expanding the scope of the Maternal Mortality Review Committee, which could enhance prevention efforts.

Separately, Minnesota last year joined the list of states to extend postpartum coverage for 12 months to those enrolled in Medicaid or the Children's Health Insurance Program. The option stemmed from provisions under the American Rescue Plan.