Women in Kansas have a harder time accessing and affording health care than in most other states, according to a new report by the Commonwealth Fund.
The report, published Thursday, ranked Kansas 32nd in the U.S. based on how well the state’s health system works for women. It placed sixth out of seven states in the Plains region, ahead of Missouri.
The ranking by the Commonwealth Fund, a nonprofit foundation that researches health issues, is the organization’s first report to focus exclusively on how all states and the District of Columbia fare on women’s health and reproductive care outcomes.
Access and affordability
Kansas scored worst on issues of health insurance coverage, provider accessibility and health care affordability.
Kansas women in their reproductive years, ages 18-44, were less likely to have health insurance than the same group nationwide. They were more likely to report not visiting a doctor for a routine checkup in the past two years. Women giving birth in Kansas hospitals are nearly twice as likely to have a self-pay insurance payment source than the national average.
Sara Collins, a senior scholar at the Commonwealth Fund and the study’s lead author, said that reflects the state’s failure to expand Medicaid.
Kansas is one of 10 states that still has not done so, despite consistent pressure by advocates and the state’s Democratic governor. Republican lawmakers have resisted expansion, arguing in part that it would be too costly.
“We see a consistent pattern across these 10 states,” Collins said. “We see much higher rates of people not accessing care due to cost.”
And even though it’s easier for women to qualify for Medicaid once they become pregnant — the program pays for around 40% of births in the state — Collins said the fact that many women lack insurance before getting pregnant can contribute to adverse maternal and infant health outcomes.
“It means that women enter pregnancy having had less access to health care, particularly if they’re poor or low-income,” she said, “and probably (in) a poorer health situation than they would be if they’d had health insurance coverage.”
Kansas has among the lowest per-capita rates of maternity care providers in the country, a signal that many women may struggle to find care.
Quality and prevention
Kansas performed better on other metrics. It has slightly lower rates of maternal and infant mortality than the national average — although the U.S. still performs worse than many other wealthy countries in these areas.
Kansas ranks near the top of U.S. states in early access to prenatal care, defined as within the first three months of pregnancy. Kansans were slightly less likely than women nationally to have cesarean sections for low-risk births, and slightly more likely to receive a postpartum checkup visit.
