Advocates, Providers Urge State Medicaid Programs to Extend Postpartum Coverage
January 7, 2021
As states face intense budget pressures during the COVID-19 pandemic and beneficiary advocates urge the federal government to provide additional financial support to state Medicaid programs, extending postpartum care access would resolve a longstanding issue impacting children and families and close a significant gap in coverage during the pandemic and beyond, according to advocates and providers.
Roughly 700 women die each year due to pregnancy-related complications, and about 60% of cases are preventable, according to the Centers for Disease Control and Prevention (CDC). The CDC also estimates that more than 44,000 pregnant women have become infected with the coronavirus this year, resulting in an estimated 8,500 hospitalizations. Medicaid is the largest payer of maternity care in the U.S., yet current law does not require state Medicaid programs to cover women for more than 60 days after childbirth, and states must seek waiver approval to use federal matching funds to extend coverage.
By Lauren Flynn Kelly
As states face intense budget pressures during the COVID-19 pandemic and beneficiary advocates urge the federal government to provide additional financial support to state Medicaid programs, extending postpartum care access would resolve a longstanding issue impacting children and families and close a significant gap in coverage during the pandemic and beyond, according to advocates and providers.
Roughly 700 women die each year due to pregnancy-related complications, and about 60% of cases are preventable, according to the Centers for Disease Control and Prevention (CDC). The CDC also estimates that more than 44,000 pregnant women have become infected with the coronavirus this year, resulting in an estimated 8,500 hospitalizations. Medicaid is the largest payer of maternity care in the U.S., yet current law does not require state Medicaid programs to cover women for more than 60 days after childbirth, and states must seek waiver approval to use federal matching funds to extend coverage.
During the public health emergency, states may not disenroll women from their Medicaid programs at 60 days postpartum. But this is only a temporary policy, and groups are urging CMS and Congress to protect access to continuous postpartum care once the crisis ends.
Prior to the pandemic, three states — Illinois, Missouri and New Jersey — submitted 1115 waivers to extend postpartum coverage, according to a Dec. 8 Health Affairs article authored by ACOG Senior Health Policy Analyst Emily Eckert. And during the pandemic, Indiana submitted a waiver seeking approval to implement a coverage extension for women with SUD.
Yet CMS has not cleared any of those waiver requests, despite its recent approval of Medicaid work requirement waivers in Georgia and Nebraska, pointed out Eckert.
During a teleconference to discuss a new report from The Commonwealth Fund and the Georgetown University McCourt School of Public Policy, public health experts on Dec. 9 explained how making short-term cuts to Medicaid to deal with budget shortfalls brought on by the pandemic could have long-term impacts to children and families, especially in communities of color. Research has shown that continued insurance coverage for children can have a wide range of long-term benefits, including better health outcomes, higher education attainment, improved earnings, reduced use of government programs as an adult and lower mortality, observed the report.