Louisiana lawmakers shelve maternal mortality resolution despite nation-leading death rates

In a state where women die from pregnancy-related causes at more than double the national average, Louisiana lawmakers quietly sidelined a resolution last week that would have forced a deeper examination of the crisis. 

House Concurrent Resolution 110, authored by Rep. C. Denise Marcelle, was voluntarily deferred in the House Health & Welfare Committee after a single objection — a move that stunned advocates who have spent years pushing for better maternal health outcomes.

HCR 110 would have required the Louisiana Department of Health to conduct a sweeping review of maternal and pregnancy-associated mortality, evaluate barriers to maternal healthcare access and delivery, and provide recommendations to improve outcomes, strengthen accountability and reduce preventable deaths statewide. 

The resolution directed health officials to examine the state’s persistently high maternal death rates — 222 confirmed pregnancy-associated deaths from 2020 to 2022, with 84% deemed preventable

It also called for a look into racial disparities that leave Black mothers 2.2 times more likely to die than white mothers.

Also suggested for review were gaps in prenatal and postpartum care, including the finding that only 5.2% of pregnant Medicaid beneficiaries received a case management plan of care.

The resolution also covered the collapse of obstetric services in rural parishes, including seven parishes with no birthing hospital, no obstetric providers and drives for patients exceeding an hour to the nearest facility.

It also sought scrutiny for workforce shortages, including 24 parishes with no OB/GYN providing Medicaid services.

Finally, Marcelle’s resolution was meant to measure the effectiveness, or lack thereof, of existing state maternal care programs.

These priorities closely mirrored the findings of the March 2025 Louisiana Legislative Auditor performance audit, which found that $383.2 million in managed care Incentive payment spending on maternal health was “not always designed to achieve measurable outcomes and, in some instances, was duplicative.” 

The audit also found managed care organizations were providing case management plans to only 5.2% of pregnant Medicaid beneficiaries, that 24 of 64 parishes had no OB/GYN providing Medicaid services, and that 18.3% of listed OB/GYN providers had zero claims — providers on paper who were not seeing patients. 

Also, the state’s own Bureau of Family Health was not consulted during the development of the spending milestones, according to the audit.

The state’s most recent 2020–22 Pregnancy-Associated Mortality Review, published days before the committee hearing, reinforced these concerns. The report found that drug overdoses have been the leading cause of pregnancy-associated death since 2018 — eight consecutive years — and that its own recommendations “may not reflect existing policies of the Louisiana Department of Health.”

The resolution also mandated the development of a statewide improvement plan and submission of a Feb. 1, 2027, report to the legislature, requiring the health department to publicly account for what is working, what is failing and why Louisiana continues to lose mothers at rates far above the national average.

But Marcelle’s proposal never made it to a vote.

Rep. Stephanie Berault, R-Slidell, argued the resolution was unnecessary, claiming “the state is already doing all of this.” 

She pointed to the health department’s existing Pregnancy-Associated Mortality Review process and ongoing federal initiatives, though the 2020–22 review states its recommendations may not reflect existing state policy, and the Legislative Auditor found that 76.4% of pregnant Medicaid beneficiaries did not receive timely prenatal care.

Berault’s comments lasted only minutes, but they were enough to halt the measure. The resolution was voluntarily deferred.

The move underscores a broader trend in Louisiana’s maternal health response: Lawmakers concede the severity of the problem, but efforts to enact meaningful systemic change repeatedly stall.

Despite years of reports documenting preventable deaths, racial inequities and failures in postpartum care, Louisiana has not implemented many of the recommendations made by its own review committees. The same categories of prevention recommendations — care coordination, substance use treatment, workforce expansion, racial disparities and data infrastructure — have appeared in every PAMR report since 2017. 

In 2018, the Legislature created the Healthy Moms, Healthy Babies Advisory Council through Act 497. The council reported recommendations in 2020 and then dissolved. By the 2020–22 PAMR, the council is no longer mentioned. Its recommendations remain unimplemented.

Louisiana’s health secretary acknowledged to the Legislative Auditor that “having coverage under Medicaid does not mean that beneficiaries have access to services.”

HCR 110 would have required a more immediate, comprehensive accounting. Instead, the legislature chose to trust that existing systems are sufficient — despite the findings of its own auditor and the health department’s own mortality review committee.

Maternal health advocates reacted with frustration, saying the decision reflects a reluctance to confront the depth of the crisis.

Dismissing the resolution as “duplicative” sidesteps the central finding of both the Legislative Auditor and the Pregnancy-Associated Mortality Review: Existing efforts have not been enough.

• 77% of the women who died had Medicaid coverage. 
• 77.5% of deaths occurred after delivery, during the period when managed care organizations are responsible for follow-up care. 
• Only 5.2% of pregnant Medicaid beneficiaries received a care plan. 

The state’s managed care system is failing to provide care management to the population most at risk, during the period when they are most likely to die.

By shelving HCR 110, critics say lawmakers avoided a public reckoning with these failures and missed an opportunity to demand accountability from state officials and the system of care.

With the resolution deferred, no new reporting requirements or oversight mechanisms will be implemented this session. The state will continue relying on existing programs that the Legislative Auditor found were not always designed to achieve measurable outcomes and that the PAMR committee’s own recommendations may not reflect.