In face of abortion ban, DeSantis says Florida is family-friendly. Is it?

Gov. Ron DeSantis says Florida is a family-friendly state that supports children — both before and after they’re born.

That’s the message he’s made in interviews and news conferences as he defended the state’s ban on most abortions after six weeks of pregnancy.

Take, for example, an interview DeSantis did in September 2023 amid his since-abandoned presidential campaign, where he said “being pro-life means for the whole kit and caboodle.”

“I think a lot of it comes down to whether women think it’s financially feasible to do that, and when they don’t get support from the father, then it can be overwhelming,” DeSantis said. “So we in Florida are sympathetic to those women in that situation.”

In the months before and since that September interview, the governor and his office have repeatedly touted several measures, including extending Medicaid for women who have recently given birth, putting money toward initiatives to support men in being parents and infusing tens of millions of dollars into the child welfare system. But while health care advocates say those moves are important steps in the right direction, they and other critics note that Florida still has a ways to go to improve maternal and children’s health outcomes.

“It’s always good to make progress,” said House Democratic Leader Fentrice Driskell, “but to pretend that progress has actually moved the needle in a significant way or solved the problem is misleading.”

Driskell said Florida is still failing pregnant women and said the new abortion ban, which went into effect this month, only makes things worse. Driskell pointed to a study that theorizes that abortion bans could drive physicians away and increase health care disparities.

Florida’s maternal mortality rate is already slightly higher than the U.S. rate, according to the Kaiser Family Foundation, which used data from 2018-2021.

“I think that the governor is trying to maybe do a bait and switch with the public,” Driskell said.

Here’s a look at some of what Florida has and hasn’t done when it comes to offering support for women and children in the last few years.

Medicaid extension vs. expansion

Florida Democrats have long called for the state to expand Medicaid — something the Republican-controlled Legislature has dismissed.

Florida, like nearly every other U.S. state, did opt to extend Medicaid for women who had given birth, from 60 days postpartum to a year. The extension was initially made possible due to a provision in the 2021 American Rescue Plan Act, and is estimated to cover about 52,000 Florida women, according to the Centers for Medicare & Medicaid Services.

DeSantis has pointed to that extension when defending his abortion policy, including in a Fox News interview last year and in news releases his office put out announcing his signing of the 15- and six-week abortion bans.

But Driskell noted that the state’s income limits on Medicaid could mean many of the women who get postpartum Medicaid coverage could be out of insurance once the year is up.

While postpartum women can be covered for Medicaid as long as they make less than 196% of the poverty level (which equates to less than $30,000 a year for an individual), the general income threshold to get Medicaid is much smaller.

Florida is one of only a handful of states — and shrinking — that have refused to expand Medicaid access. In states where Medicaid has been expanded, maternal and infant mortality has decreased, according to research from the University of Miami.

“If you are a low-income parent in Florida, we don’t offer much beyond the bare essentials required by federal law,” said Alison Yager, the executive director of the Florida Health Justice Project.

Yager also noted that she’s heard of some postpartum women who have lost Medicaid coverage before the year is up, some of whom are now plaintiffs in an ongoing lawsuit against the state. She said problems are likely due to a need for better training for state employees to make sure they don’t inappropriately tell someone they’re ineligible, as well as more education for people who could be eligible for benefits.

According to America’s Health Rankings, about 18% of women aged 19-44 in Florida are uninsured, based on 2021 data. Only Georgia, Mississippi, Oklahoma and Texas have higher uninsured rates for women of reproductive age.

The Department of Health has long offered some programs for pregnant women regardless of insurance coverage, including Healthy Start, a home visitation program that is partially federally funded and offers parenting education to expectant mothers and families.

The department also points to a program that provides minority mothers with blood pressure and blood sugar measuring tools, nutrition counseling, lactation support, and connections to social services, child care options and housing options. DeSantis and state lawmakers this year set aside $23 million annually for that program, which began as a pilot in 2021 after being sponsored by House and Senate Democrats. (The same bill this year also set aside about $134 million annually to improve reimbursement rates for pediatric and obstetric care.)

The program for minority mothers aims to counteract the especially negative outcomes Black mothers see during pregnancy. For example, Black mothers in Florida have a nearly 1.5 times higher preterm birth rate than non-Black mothers, according to the March of Dimes, and infant mortality for Black babies is 1.8 times higher than the state rate. This past fiscal year, the program served over 3,700 women, none of whom suffered any maternal or infant deaths, a Department of Health spokesperson said.

Children’s health coverage and wellness

After the U.S. Supreme Court overturned Roe v. Wade’s federal abortion protection, DeSantis responded by saying that Florida would expand “pro-life protections” and would “stand for life by promoting adoption, foster care and child welfare.”

His office has since highlighted a bill DeSantis signed in 2022 (before Roe was overturned) that increases monthly payments for foster children’s caregivers. The bill gives caregivers of young children through preschool an extra $200 monthly for early learning or child care programs. Budgets DeSantis has signed have also infused millions of dollars into the foster care system.

In response to questions for this story, the governor’s office offered a long list of initiatives they say have supported women and children, including a 2023 bill he signed that helps former foster kids get workforce education.

Florida lawmakers last year also unanimously expanded the number of children eligible for KidCare, a government-subsidized health insurance program for children, a move estimated to allow 42,000 more children to qualify for the program, according to a Senate bill analysis.

But its implementation has been delayed by an ongoing battle between Florida and the federal government.

Florida challenged the federal government over a rule requiring states to provide health coverage for a certain time after a premium is paid, even if parents stop paying after that.

Florida’s Agency for Health Care Administration has said that the federal government’s rule harms the “integrity and long-term stability of the program” and could lead to a loss of around $48 million annually in revenue with the expanded eligibility. The state also argued that providing the continuous coverage required for children to stay on the rolls would cost them about $1 million each month.

Joan Alker, the executive director of the Georgetown University Center for Children and Families, said the federal government pays for the vast majority of Florida’s health coverage for poor children. She also said Florida has long had a higher rate of uninsured children than other states, in part because of how Florida has set up red tape around enrollment, and noted that Florida is the only state that has challenged the federal rule.

She said that most uninsured kids, in Florida and nationwide, are eligible for health coverage, but lose coverage when the time comes to renew because of red tape. Alker supports the federal rule to keep kids enrolled even if their parents miss a premium payment.

“It’s not that hard to keep kids healthy in most cases, thankfully, but it does require regular continuous care,” Alker said.