The Trump administration wants to let states extend Medicaid for pregnant women battling addiction so they would remain insured by the government a year after giving birth.
The request, of $25 million for 2021, was tucked into President Trump’s budget proposal released Monday. The addition may reflect the influence of first lady Melania Trump, who has visited healthcare facilities to draw attention to moms and babies born dependent on opioids.
The overall spending proposal, which presidents put out annually, is used as a starting point for negotiations and tends to be ignored by Congress as they deliberate on government spending. This particular provision, however, is likely to be well-received by House Democrats.
The idea stands in sharp contrast to other parts of Trump’s budget, which calls for curbing Medicaid enrollment rather than an expansion. The healthcare program, which is jointly funded by the federal government and states, pays for care for the poor and for pregnant women, people with disabilities, and the elderly. The Trump administration and conservatives in Congress oppose the way that Obamacare extended Medicaid to the poor, saying funding for the program should be reserved only for the most vulnerable. Other parts of Trump’s budget call for people on Medicaid to work in order to be on the program.
But there’s at least one population the Trump administration views as favorable for Medicaid expansion. Under federal law, pregnant women without health insurance can be enrolled in Medicaid, but then are dropped two months after they give birth. The Trump administration wants to see women with addictions receive coverage, which would include treatment for drug addiction, as well as any other medical needs, for up to a year after birth.
That provision could be something that states change individually through a waiver or that Congress expands to all states through federal law.
This isn’t the first time that expanding Medicaid to pregnant women for longer has come up among policymakers. A House bill, supported by 106 Democrats and one Republican, called the Mothers and Offspring Mortality and Morbidity Awareness Act, or “MOMMA Act,” would expand coverage for Medicaid for up to a year for all pregnant women who are enrolled in the program. The bill is intended to help address the rise in maternal deaths and disability that have been observed in the United States each year. Data are spotty, but they suggest that about 65,000 women have serious medical problems after they give birth, and 900 women die.
It isn’t clear why women are dying, but the numbers appear to be rising — a trend not observed in other developed countries — and many are linked to conditions involving bleeding or high blood pressure. Many occur several weeks after women leave the hospital, and it’s possible that a portion of the deaths may be linked to drug and alcohol addiction.
