Report Card: States Rejecting Medicaid Expansion Get Poorest Grades on Women’s Health

The Alliance for a Just Society has released a Women’s Health Report Card that reveals which states get poor and failing grades when it comes to women’s health and to ensuring access to quality, affordable and timely health care – important measures of states’ public health infrastructure.
Tuesday, October 14, 2014
Contact: Kathy Mulady,


Report card highlights persistent racial disparities in women’s health in every state

Seattle, WA—Seventeen of the 21 states that rejected federal funds to expand health coverage through Medicaid received final grades of C, D or F in a new 50-state report card on women’s health – and 13 states got a D or F grade. Even in states with better overall grades, persistent racial disparities indicate that most states are failing to meet the health care needs of women of color.
States with the worst grades when it comes to women’s health are Mississippi (ranked #50), Oklahoma (#49), Texas (#48), Nevada (#47) and Arkansas (#46). States with the best rankings are Massachusetts (#1), Connecticut (#2), Hawaii and Vermont (tied for #3) and Minnesota (#5).
The Promise of Quality, Affordable Health Care for Women: Are States Delivering? is a 50-state report card on women’s health released today by the Alliance for a Just Society. The report card provides an important measure of states’ records on women’s health as politicians court women voters ahead of the November elections, and continue to debate whether to accept federal funds to expand Medicaid coverage in more than 20 states.
The 50-state report card is available at:
“This report card shows that most of the states that are still refusing funding for Medicaid expansion have poor or failing records on women’s health. These states are failing women and the families that depend on them,” said LeeAnn Hall, executive director of the Alliance for a Just Society. “It’s time for governors and legislators in these states – from Texas to Maine and Florida to Montana – to move forward with expanding health coverage to uninsured women through Medicaid.”
Representative Jan Schakowsky (D-IL) credits the Affordable Care Act with helping improve women’s health through expanded coverage, cost-free access to contraception and other preventive health services, and the elimination of gender-based insurance discrimination.
“While many states are making critical progress on women’s health thanks to the Affordable Care Act, this Report Card underscores that we must do more, starting with getting every state to cover low-income women through Medicaid,” said Schakowsky.
States with poor records have the opportunity to improve women’s health coverage by accepting federal money to expand Medicaid, said Judy Waxman, vice president for Health and Reproductive Rights at the National Women’s Law Center.
“But if leaders in these states continue to drag their feet, they’re only going to fall further behind. No woman should be denied health care for any reason,” said Waxman.
The report card shows that all 50 states are failing to meet the health care needs of women of color. Latina women are uninsured at much higher rates than other women in almost every state. Black, Latina, Asian/Pacific Islander and Native American women have worse outcomes on key health measures in most states.
“These race-based differences are shocking – and unacceptable. These disparities make it clear that the debate over Medicaid expansion must end,” said Jessica González-Rojas, executive director of the National Latina Institute for Reproductive Health. “It’s time for politicians to stop bickering and take action to improve health for all women – including women of color – by moving forward with Medicaid expansion.”
With women making up an increasing share of primary breadwinners, women’s health is of critical importance for family economic security.
“Low-income women in more than 20 states who are doing everything they can to support their families are being denied access to affordable health care because of state leaders’ stubborn refusal to accept the federal funding to expand Medicaid,” said Yael Foa, outreach director for Working America.
“This is a national issue, and it hits working class people the hardest. In some cases, women are patching together a living through 2, 3 or 4 part-time jobs that don’t offer health care,” said Foa. “Our families and our economy depend on women. Women should be able to depend on their states for quality, affordable health care.”
The Promise of Quality, Affordable Health Care for Women: Are States Delivering? report card uses the latest available data from government and other sources to rank the 50 states on 30 measures relating to women’s health. It generates state rankings and grades in three subject areas (health coverage, access to care, and health outcomes), an assessment of race-based disparities, and a final rank and grade for every state. It includes specific recommendations for improving women’s health.
The Alliance for a Just Society is a national policy, research and organizing network focused on racial and economic justice. The Alliance has produced pivotal reports on state and national health issues including Medicaid/CHIP, prescription drugs, and insurance industry practices for 20 years.