States are working to extend Medicaid coverage for postpartum healthcare services, even red states that chose not to extend Medicaid eligibility through Obamacare.
Illinois, Missouri, and South Carolina have submitted waivers to the Department of Health and Human Services requesting approval to extend the Medicaid postpartum coverage period for a year.
And states that have not expanded Medicaid under Obamacare are considering legislation to extend coverage: Georgia, Missouri, Wisconsin, Tennessee, and Texas.
Some of those states have been spurred by the problems facing new mothers. Georgia, Texas, and Missouri have some of the highest rates of mothers who die during or up to a year after giving birth. The U.S. maternal mortality rate more than doubled from 10.3 per 100,000 live births in 1991 to 23.8 in 2014. The Commonwealth Fund found that, among 11 high-income countries, the United States has the highest share of women dying from pregnancy complications, many of which are preventive.
It’s a problem that has caught the attention of legislators on Capitol Hill. Democrat Robin Kelly decried the lack of extended postpartum care under Medicaid, which ends after 60 days of giving birth, in a February Energy and Commerce Committee hearing. Extending Medicaid eligibility periods for new mothers, she said, could protect the 12% of women who experience health emergencies after the standard 60 days of postpartum Medicaid coverage.
“Experts agree that expanding Medicaid to ensure new moms can see their doctor will keep them, their babies, and families healthy,” Kelly told the Washington Examiner. “It’s time to create a system where new moms, 70% of whom will have at least one complication after giving birth, can see their doctors.”
Kelly’s Helping MOMS Act, which advanced out of the Energy and Commerce Committee in November 2019 by voice vote, would create an option for states to develop plans to extend coverage up to 12 months without having to go through the waiver process. She called extending postpartum coverage “the biggest thing that we need.”
The American College of Obstetricians and Gynecologists began advocating for extended postpartum Medicaid coverage when Kelly introduced the act in 2019, which the organization’s senior health policy analyst Emily Eckert said effectively drew Congress’s and the public’s attention to alarming maternal mortality rates due to lack of health coverage.
“That bill is a little more palatable because it’s not amending statute and making all states extend the coverage,” Eckert told the Washington Examiner. “It’s presenting it as an option for states to extend coverage to help improve their maternal mortality rates.”
While the states that have submitted waivers come up short of the full 12-month extension that ACOG and Kelly advocate for, incremental steps are better than no steps, in Eckert’s view.
For example, New Jersey, a state that expanded Medicaid under Obamacare in 2014, submitted a waiver request to extend postpartum Medicaid coverage through 180 days.
Eckert called it “incremental change” that she is confident will become comprehensive coverage.
“It doesn’t sort of meet the threshold that ACOG national would like to see all women in the country have … but we’re not in any way trying to trample those efforts,” Eckert said. “We think any improvement on the status quo for all women would be wonderful.”
