Family Values Means Covering Families: Parents Need to Focus on Parenting, Not Access to Care.

Abstract

Child health depends on family health. In this issue of Pediatrics , Johnston et al1 clearly illustrate challenges facing low-income mothers in gaining access to health insurance during the first year after childbirth. Although highlighting the positive impact of Medicaid expansion through the Patient Protection and Affordable Care Act (in some states), the number of mothers who are uninsured before, during, and after pregnancy in the United States is alarming. Of 185 World Health Organization member states with a population >100 000, the United States and the Dominican Republic were the only countries where maternal mortality increased between 2000 and 2017.2 Women with preexisting chronic conditions, living in poverty, and belonging to a racial and/or ethnic minority are disproportionately affected.3 Studies of women who have delivered a child have found that one-quarter were uninsured in the month before pregnancy, and more than half of the mothers had <12 years of education.4 Johnston et al1 draw attention to this critical issue while elucidating a partial solution: expanding access to health insurance through the Medicaid program. Not surprisingly, they found that … Address correspondence to Tina L. Cheng, MD, MPH, Department of Pediatrics, Johns Hopkins Children's Center, 1800 Orleans St, #8491, Baltimore, MD 21287. E-mail: tcheng2{at}jhmi.edu