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More than half of all states have expanded access to Medicaid, CHIP postpartum coverage

Extending Medicaid and CHIP coverage in Georgia and Pennsylvania is expected to impact about 57,000 people.

Jeff Lagasse, Editor

Photo: Jose Luis Pelaez Inc/Getty Images

More than half of all states across the country have expanded access to 12 months of Medicaid and Children's Health Insurance Program coverage after pregnancy, according to the Department of Health and Human Services.

Georgia and Pennsylvania are the 25th and 26th states to be approved for the extended coverage, made possible by provisions in the American Rescue Plan signed into law by President Biden in March 2021.

It's estimated that up to an additional 57,000 people in those two states will now be eligible for Medicaid or CHIP for a full year after pregnancy. In total, an estimated 418,000 Americans across 26 states and Washington D.C. now have expanded access to postpartum coverage.

The administration has consistently framed the ARP and postpartum coverage push as part of a larger effort to expand health insurance coverage, particularly in underserved areas and among disadvantaged populations.

"Last year, I launched a Call to Action for states to extend Medicaid coverage for postpartum women from 2 months to 12 months," said Vice President Kamala Harris by statement. "Medicaid covers approximately 40% of all births nationwide, and one-fourth of pregnancy-related deaths occur between one and a half months and one year postpartum. As of today, more than half of states have heeded this call, achieving an important milestone that will significantly impact women and families. Our Administration will keep fighting until every woman has access to expanded postpartum Medicaid coverage."

WHAT'S THE IMPACT?

The coverage extension was made possible by a new state plan authority established by the ARP, under which states may extend postpartum coverage in their Medicaid and CHIP programs from the current mandatory 60-day period to 12 months. 

Georgia and Pennsylvania are the most recent states to extend Medicaid and CHIP coverage for 12 months following pregnancy, joining California, Connecticut, Florida, Hawaii, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, North Carolina, Ohio, Oregon, South Carolina, Tennessee, Virginia, Washington, Washington D.C. and West Virginia. 

The Centers for Medicare and Medicaid Services continues to work with other states that have proposed adopting the ARP option to extend postpartum coverage. Medicaid covers 42% of all births in the nation and more than half of all children in the country, according to HHS.

As noted in a report published by the HHS Office of Assistant Secretary for Planning and Evaluation, one in three pregnancy-related deaths occur between one week and one year after childbirth. The postpartum period, said HHS, is critical for recovering from childbirth, addressing complications of delivery, ensuring mental health, managing infant care and transitioning from obstetric to primary care.

CMS is also taking another step forward with its Maternity Care Action Plan by releasing data indicating if a hospital participated in a state or national program aimed at improving maternal and child health. This is the first in a series of updates being made to a new "Maternal Health" section of Hospital Compare. In the future, a "Birthing-Friendly" hospital designation will be used to identify hospitals that participate in a statewide or national perinatal quality improvement collaborative program and have implemented the recommended quality intervention.

THE LARGER TREND

An estimated 15 million people could lose Medicaid coverage when the COVID-19 public health emergency ends due to the unwinding of the continuous enrollment requirement. Children and young adults will be impacted disproportionately, with 5.3 million children and 4.7 million adults ages 18-34 predicted to lose Medicaid/CHIP coverage, according to a report released in August from the Department of Health and Human Services.

The PHE is in effect until mid-January 2023.

Extending Medicaid and CHIP coverage is part of CMS' Maternity Care Action Plan, announced in July. CMS said it's also working to expand its data collection efforts, build a better understanding of key demographic drivers of health to identify disparities in care or outcomes, and coordinate across programs to identify gaps and best practices.

CMS said it will also engage with states, providers and other stakeholders to improve maternal care among Medicaid, CHIP, Medicare and Health Insurance Marketplace enrollees. It will also work with states and sister agencies to expand and improve access to the maternity care workforce, including midwives and community-based practitioners such as doulas and community health workers.

Also in July, HHS' Office of the Assistant Secretary for Health announced it was investing $8.5 million in initiatives designed to reduce both pregnancy-related deaths and complications that disproportionately impact minority populations and people living in rural areas. OASH announced 25 winners of the first phase of the HHS Racial Equity in Postpartum Care Challenge. American Indian/Alaska Native and Black women are two to three times more likely to die from a pregnancy-related cause than Caucasian women, the agency said.
 

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com