内容摘要：Health Secretary Robert F. Kennedy Jr. has called the federal dietary guidelines requiring

Health Secretary Robert F. Kennedy Jr. has called the federal dietary guidelines requiring

Tennessee is one of 10 states — many of them in the South — that haven’t expanded Medicaid. Michael Meit, the director of East Tennessee State University’s Center for Rural Health Research, believes doing so would be an obvious solution to the problem of growing rural health disparities. More people would be covered by insurance, Meit said, and hospitals could make more money.“They’re providing a lot of uncompensated care,” he said of rural health systems in those states.

Miller acknowledged that Medicaid expansion can help, but argued that pinning hopes on that alone has “let the private insurance plans off the hook.”“In some cases, the small hospitals are losing more money on private insurance than they are on Medicaid, which is really kind of remarkable,” he said, “but that’s how little they get paid ... by the private insurance plans.”Low Medicaid reimbursements play a role in

, along with worker shortages and declining birth rates. More than half of rural hospitals have stopped offering labor and delivery services, another recent analysis from the Center for Healthcare Quality and Payment Reform showed. That can lead to longer travel times and awhen she was pregnant with her second child. There is no labor and delivery unit at the hospital in Rocky Mount, Virginia, and a hospital about 40 minutes away closed in 2022. Ratliff, who is Black, instead went to Salem — more than an hour away — for every prenatal visit. She ran through all of her paid time off, and had no paid maternity leave.

She did, however, have a doula. The doula is Black and her services were covered by Medicaid — a benefit Virginia started offering in 2022.

“I really did want somebody else to just help advocate, especially since with women of color, the mortality rates are higher. So I was like, ‘anything can happen,’” she said. “My family members never had good experiences up here at these doctors’ offices, even just for regular appointments.”Midwife Celena Brown examines Kayleigh Sturrup during a pregnancy checkup. Midwives at Commonsense Childbirth are striving to provide good, accessible care. Experts cite the nonprofit, started by an immigrant from the U.K., Jennie Joseph, as model for helping reduce maternal mortality. Tuesday, June 25, 2024 (AP Photo/Laura Ungar)

Midwife Celena Brown examines Kayleigh Sturrup during a pregnancy checkup. Midwives at Commonsense Childbirth are striving to provide good, accessible care. Experts cite the nonprofit, started by an immigrant from the U.K., Jennie Joseph, as model for helping reduce maternal mortality. Tuesday, June 25, 2024 (AP Photo/Laura Ungar)The Scandinavian country and many other European nations also have generous paid leave, which research links to better postpartum health. Norway mandates

between maternity, parental and home care leave. The U.S. requires none.Virginia Kotzias, who grew up in the U.S. but now lives in Norway, suffered two first-trimester miscarriages. She had the option to stay in the hospital, which she chose to do the first time because she was scared.