Now is The Time! With the passage of the American Rescue Plan, a new option for states to extend postpartum coverage to new mothers for 12 months is established!
Something urgently needs to be done to respond to the alarming maternal mortality crisis in the U.S., which disproportionately affects women of color. When Medicaid and CHIP expires just 60 days after the end of pregnancy many women are at risk of becoming uninsured and missing out on critical access to care that can prevent pregnancy-related deaths.
Our current system of publicly supported coverage options for pregnant and postpartum women is a complex patchwork that varies tremendously by income, immigration status, and state, leaving many new mothers uninsured.
Postpartum care encompasses a range of important health needs, including recovery from childbirth, follow up on pregnancy complications, management of chronic health conditions, access to family planning, and addressing mental health conditions. While postpartum care has traditionally centered around one clinical visit six to eight weeks after delivery, there has been a paradigm shift to emphasize that postpartum care is an ongoing process that typically requires multiple visits and follow up care that may last a year or even longer. This is particularly important for those who experience pregnancy complications or have chronic conditions, such as hypertension or diabetes.
There is substantial evidence pointing to the importance of insurance coverage during the postpartum period. Extending pregnancy-related Medicaid/CHIP coverage for 12 months postpartum could increase the number of Americans with insurance during the postpartum period while expanding access to needed health care. Approximately 123,000 of the nation’s estimated 440,000 women uninsured during the first year postpartum would likely be newly eligible for Medicaid or the Children’s Health Insurance Program (CHIP) if pregnancy-related coverage were extended for 12 months.
Together with existing Medicaid and marketplace coverage, an extension of postpartum Medicaid coverage would mean that 70% of uninsured women would likely be eligible for some type of publicly subsidized coverage during the postpartum period.
Postpartum Medicaid Expansion is Supported by:
American Medical Association
American Academy of Family Physicians
American Academy of Pediatrics
American College of Physicians
American Osteopathic Association
American Psychiatric Association
Society for Maternal-Fetal Medicine.
March of Dimes
Black Mamas Matter Alliance
American Hospital Association
Medicaid Health Plans of America
America’s Health Insurance Plans.
Policy Opportunities:
In 2019 and 2020, five federal bills were proposed to extend Medicaid/CHIP coverage for 12 months continuously following the end of pregnancy, reflecting various approaches to financing and required state actions. The Helping Medicaid Offer Maternity Services (Helping MOMS) Act of 2019 (H.R. 4996), which would allow states to adopt an extension without requiring a federal waiver, was approved by the U.S. House of Representatives in September 2020 but was not considered by the Senate.
In 2019, Wisconsin legislators Senator Erpenbach and Representative Kolste introduced AB 346and SB 324 to expand Medicaid coverage for postpartum women for one full year in Wisconsin. Sadly, these bills never got a hearing and were not advanced last legislative session.
In 2021, Governor Evers included a proposal to expand postpartum Medicaid coverage for one year in his State Budget proposal.