CA stepped up on abortion access. Here’s the next step toward reproductive justice | Opinion

The impacts of Roe v Wade being overturned are detrimental and will exacerbate economic and racial disparities for those who cannot choose the outcome of their pregnancy.

California stepped up to become a model state in abortion access. Now, the golden state should uphold its reputation as a reproductive justice leader by doing the same for pregnancy support through pregnancy-specific health insurance.

The Kaiser Family Foundation found that health costs associated with pregnancy, childbirth and post-partum care average more than $18,000, with out-of-pocket payments of around $2,854 for people with group health insurance. These out-of-pocket costs are often more than a family can afford in a short amount of time. About one-third of households do not have the money needed to cover these costs.

A little less than half (42%) of people who gave birth in 2020 used Medicaid to cover pregnancy and birthing costs, which has little or no out-of-pocket liability. Meanwhile, 12% of women of childbearing age had no insurance at all. California’s Medi-Cal Access Program does cover uninsured pregnant women, however, these Medi-Cal services can still have out-of-pocket costs.

Whether Californians have insurance or not, the cost of having a baby can be sky-high.

Covering these costs is especially important given the racial and socio-economic disparities that persist in the U.S., including here in California. Black women are three times more likely to die from pregnancy-related causes than white women, and women of color are up to 50% more likely to give birth prematurely. These racial disparities in pregnancy also result in health disparities for their children — Black babies are more than two times more likely than white babies to die before age one.

I hear concerns directly from pregnant people I work with who need support; who are asking about insurance costs; are worried about preterm birth; or are trying to get access to doulas and emotional support. While working on the Perinatal Equity Initiative for the County of San Diego Health and Human Services Agency, we asked community members experiencing pregnancy inequities about the reasons they think there are high rates of infant mortality and preterm births for Black women. The majority of the answers were about the lack of social and economic support for the mothers because either the support is not available or they simply don’t know about existing resources.

It’s been years since the start of California’s Perinatal Equity Initiative, and yet we are still witnessing high burdens for our pregnant community members.

California must create a statewide policy for full coverage of comprehensive pregnancy, childbirth and post-partum health insurance with no out-of-pocket costs. Reproductive justice calls for us to support people whether they want to have a child or not, and to raise their children in safe and supportive environments.

California is taking important steps to protect people who decide to end their pregnancies. We must do the same for people who are building their families here.

Just as the California legislature recently signed a no out-of-pocket cost for medical abortion policy, they should pass a bill guaranteeing that people have pregnancy insurance with no out-of-pocket costs. The insurance should encompass full coverage for prenatal, childbirth and postpartum care.

The post-Roe era is a time for California to be a leader in all aspects of reproductive justice and pave a path of support for all people of reproductive age.