The Clark County Board of Health approved a resolution Wednesday that commits to advancing efforts to increase pregnancy-related care for Medicaid clients in Clark County.

“Pregnancy embodies great hope in the creation of our next generation, a newborn. Everyone deserves the very best care to ensure that moms and the new lives they are nurturing have the healthiest start possible,” said Sue Marshall, Board of Health chair.

Prenatal care improves the chances of a healthy pregnancy. Receiving prenatal care early and throughout pregnancy can prevent and reduce the risk of complications for both the birthing parent and the baby. Inadequate prenatal care increases preventable risk for pregnancy complications and adverse birth outcomes for pregnant individuals and their babies.

In Clark County last year, more than 2,000 births were covered by Medicaid and of those, about 31% received inadequate prenatal care. Among the more than 3,300 births covered by private insurance, about 22% received inadequate prenatal care.

In addition to inequities by insurance type, significant inequities in access to prenatal care also exist by race and ethnicity. Pacific Islander, Asian and Black families with Medicaid were most impacted by inadequate prenatal care, with 31-61% of births among those populations receiving inadequate care. 

“The prospect of not being able to access prenatal care or not being able to access care until very late in one’s pregnancy is deplorable. That is why the Board of Health has directed Clark County Public Health to prioritize advancement of efforts to close the Medicaid gap. Breaking down barriers to quality prenatal care is our objective,” Marshall said. 

The resolution passed by the Board of Health commits the board and Public Health to supporting efforts to implement Medicaid payment reform initiatives, strengthen the maternal health care workforce, increase transparency of health care access for Medicaid clients, and champion partnerships to collaboratively develop solutions, among other efforts.

Previous activities addressing prenatal care access 
In fall 2023, a community provider notified Public Health that Medicaid clients seeking prenatal care in the community were unable to find available appointments, sometimes waiting weeks or months to get care. Public Health worked with the Washington State Health Care Authority and local managed care organizations to provide guidance for pregnant Medicaid clients struggling to access prenatal care. 

In 2024, Public Health completed a comprehensive analysis of birth certificate data to illuminate the adequacy of prenatal care among the birthing Medicaid population in 2023. That analysis was used to develop an issue brief with recommended action steps for health systems and organizations serving pregnant and parenting families in Clark County. 

In April 2025, Public Health gave a presentation to the Board of Health detailing the significant inequities for the Medicaid population compared to people with private insurance. Following the presentation, the Board of Health convened a Medicaid Access to Prenatal Care Policy Summit in June to elevate and prioritize policy opportunities to address the root causes of inadequate access to prenatal care for Medicaid clients.

Public Health’s immediate next steps include convening local health care system partners to explore opportunities to fund and implement culturally congruent group prenatal care and support existing and future workforce capacity, champion efforts to increase data quality and transparency of health care access for the Medicaid managed care population, and continue collaboration with state partners to assess legislative opportunities for payment reform.  

For more information, visit the Public Health website.  

MEDIA CONTACT
Marissa Armstrong, communications manager
564.397.7307; marissa.armstrong@clark.wa.gov