Montana mothers and could-be moms rely more on Medicaid than in other states, and would be harder hit by proposed cuts to the program.

More than 30% of Montana women of childbearing age are covered by Medicaid. It's the seventh-highest rate in the nation and about 7% higher than the national average. That's according to a new report from Georgetown University's Center for Children and Families, which also shows Montana is home to three of the nation's 20 most Medicaid-dependent counties: Glacier, Prairie and Big Horn.

Joan Alker, the Georgetown center's executive director, notes all 20 counties are in states that adopted Medicaid expansion.

"Rural communities tend to have lower income than metro areas," Alker said. "So Medicaid, as important as it is for moms and babies nationwide, is even more important in rural areas and small towns."

House Republicans have proposed cutting more than $600 billion in Medicaid funding to pay for Trump administration priorities, including mass deportations and tax cuts. The Congressional Budget Office estimates the proposed cuts would drop more than 8 million Americans from Medicaid benefits.

Obstetric care has high fixed costs for hospitals, including dedicated space and equipment and 24/7 staff availability. Katy Backes Kozhimannil, a professor in the Division of Health Policy and Management at the University of Minnesota, and co-director of the university's Rural Health Research Center, said covering costs can be more challenging for rural hospitals.

"The revenues to cover these fixed costs are variable and depend on the volume of births at each hospital, which disadvantages lower birth volume facilities," she continued. "And the reimbursement rate for each birth is another factor that leads into revenues."

Kozhimannil said in 2022, more than half of hospitals in rural America did not offer obstetric care, following the closure of nearly 550 obstetric units since 2010.

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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