MEMPHIS, Tenn. (AP) — States with restrictive abortion laws generally have more permeable safety nets for mothers and youthful children, according to a recent study and an analysis by The Associated Press.
Tennessee is an example of how this plays out. Tennessee residents of childbearing age are more likely to live in the desert of maternal care and face an overall physician shortage. Women, infants and children are less likely to participate in a government nutrition program called WIC. And Tennessee is one of only 10 states that have not expanded Medicaid to a larger share of low-income families.
The AP reported on how safety net programs in Tennessee and states with similarly strict abortion laws often fail families. Here are some key takeaways.
Medicaid doesn’t cover as many low-income residents
The Republican supermajority in the Tennessee Legislature has long rejected efforts to expand Medicaid to people earning up to 138% of the federal poverty level — about $35,600 for a family of three.
Earlier this year, a federal judge ruled that TennCare – the state’s Medicaid program – illegally terminated coverage for thousands of families and responded “lethargically” when nearly 250,000 children lost coverage because of paperwork problems.
Republican Gov. Bill Lee argues that his administration has improved services. For example, in 2022, Medicaid coverage for mothers was increased from 60 days postpartum to one year, allowing an additional 3,000 mothers to benefit from the program each year.
The state also raised the Medicaid income limit for parents to the poverty level — nearly $26,000 for a family of three — and began offering recipients 100 free diapers a month for babies under two.
“Pro-life is much more than protecting the lives of the unborn,” Lee said in his annual address to lawmakers in 2023, and recently reiterated it on social media. “This is not a question of politics. This is about human dignity.”
Safety net programs can be complex to navigate
Mothers described several assistance programs as fraught with bureaucracy and other challenges.
Anika Chillis of Memphis participated in WIC for several months after her son was born, but then went without it due to a mistake during the renewal process – eventually being restored with the facilitate of the nonprofit Tennessee Justice Center.
Taylor Cagnacci of Kingsport, who is pregnant and has a 1-year-old child, said she participated in the federally funded Supplemental Nutrition Assistance Program — formerly known as food stamps — for a time, but missed an appointment and was unsure of the next steps . The recertification process gave her “such a big headache” that she gave up SNAP.
“I just felt like it was intentionally made so difficult for me that I would just give up,” she said.
The problems extend beyond Tennessee. Women with youthful children in states that ban abortions or limit them to the first weeks of pregnancy said it can be complex to receive social services there, according to a survey by health research organization KFF. Nearly half said it is complex for women in their state to get food stamps, for example, compared to three in 10 in states where abortion is widely available.
Charities cannot fill the gap
According to a recent report, 30% of Tennessee’s 2.8 million households earn above the poverty line, but not enough to afford the basic cost of living in their county. They are often not entitled to state aid.
A fragmented patchwork of charities can facilitate, but they don’t cover the entire state. Some nonprofits are prevented from helping by government agency income rules. And most charities are constrained by the ebb and flow of donations.
Nonprofit leaders fear security vulnerabilities could widen with a recent administration in Washington and a GOP-controlled Congress. Republicans could seek significant changes to federal aid programs they have long criticized, such as Medicaid and food stamps.
“We went through four years of a Trump administration, and the goal of the Trump administration was to cut welfare,” said Signe Anderson, senior director of nutrition promotion at the Tennessee Justice Center. “I’m worried … about families in Tennessee and across the country.”
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Kruesi reported from Nashville, Tennessee. AP data journalists Kasturi Pananjady and Nicky Forster contributed to this report.
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The Associated Press Health and Science Department receives support from the Science and Educational Media Group of the Howard Hughes Medical Institute and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
