On Tuesday, the U.S. Department of Health and Human Services and the Centers for Medicare and Medicaid Services approved expanded coverage of postpartum Medicaid and Children’s Health Insurance programs in Hawaii, Maryland and Ohio. All states should follow suit, one advocate said.
Through the American Relief Program, states have the option to extend postpartum coverage in their Medicaid and CHIP plans from the currently mandatory 60-day schedule to 12 months after pregnancy. The state can make changes through the State Program Amendment, a proposed change to the Medicaid program. This option cost eValid for 5 years according to April 1 Kaiser Family Foundation. Until April 1, states expanded postnatal insurance coverage through Section 1115 waivers or the use of state funds.
An extension is needed, Dr. Jen Villavicencio, Head of Equity Transformation, American College of Obstetricians and Gynecologists.The organization has been leading advocate Extend postpartum Medicaid coverage to one year. About a third of maternal deaths occur between a week and a year after giving birth, she said.
“The first few weeks of birth are a critical health period for an individual… The postpartum period must include ongoing access to healthcare, not one visit, with services and support tailored to each individual’s needs – especially for patients with chronic diseases,” Villavicencio said. “This requires timely follow-up and ongoing coordination of care with other healthcare professionals in order to lay the foundation for long-term health and well-being. Without health insurance, however, it will be difficult for people to access this care.”
So far, 21 states and the District of Columbia are implementing postnatal insurance extensions, while nine states are ready to implement them pending CMS approval. Tracker by ACOG.
Medicaid cover 42% of births nationwide. With Tuesday’s approval, 34,000 people each year will be eligible for postpartum Medicaid and CHIP coverage within 12 months of pregnancy, HHS said in a report. Press Releases. This includes about 2,000 in Hawaii, 11,000 in Maryland and 21,000 in Ohio. In total, about 318,000 Americans qualify each year, HHS said.
Of the 12 states that chose not to fully expand Medicaid, 9 have sought or plan to expand postpartum Medicaid coverage, Kaiser Health News reported in June. But some politicians in non-expansion states like Wyoming, South Dakota and Mississippi do not want any form of Medicaid expansion, including postpartum insurance.
If all states adopted the 12-month postpartum option, about 720,000 Americans each year would receive Medicaid and CHIP coverage within a year of pregnancy, HHS said.
“Through the American Relief Program Act, Congress gave states an easier path to expand Medicaid coverage for pregnant women,” Villavicencio said. “Every state should take advantage of this opportunity.”
Under the Covid-19 public health emergency, states must provide ongoing coverage for Medicaid enrollees, the KFF said. Thus, postpartum coverage has been continuous throughout the pandemic.
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