Washington, D.C. – (December 1, 2020) – Modern Medicaid Alliance partners are emphasizing the urgent need to address maternal health during the final weeks of the 116th Congress. Congressional action is critically needed to address rising maternal mortality rates and disparities in health outcomes, and ensure affordable, high-quality health care and services for pregnant and postpartum women. Specifically, the Modern Medicaid Alliance hopes that the United States Senate will join the House of Representatives in passing bipartisan legislation to continue Medicaid and CHIP coverage for 365 days, or 12 months, postpartum.
The U.S. has the highest maternal mortality rate – that is, deaths within one year from the end of a pregnancy – of any developed country. In fact, maternal mortality has jumped from 10.3 per 100,000 live births in 1991 to 17.4 in 2018. Women of color account for a disproportionate number of those deaths. Black and American Indian/Alaska Native women are 3.3 and 2.5 times more likely, respectively, to die from pregnancy-related causes than non-Hispanic white women.
Under current law, all states provide Medicaid coverage for pregnancy-related services to women with incomes up to 138% of the federal poverty level (FPL) through 60-days postpartum. However, research indicates that women have significant medical needs up through the first year after delivery and the mother’s health is connected to their child’s health and wellbeing. According to the Mayo Clinic, a pregnancy within 6 months of a live birth is associated with increased risks to the baby’s health such as premature birth, the placenta partially or completely peeling away from the inner wall of the uterus before delivery (placental abruption), low birth weight, congenital disorders, and schizophrenia. New mothers also face significant health risks postpartum, with 52% of pregnancy-related deaths occurring between delivery and one year postpartum.
Medicaid is key to improving maternal health and addressing disparities in outcomes. As the largest health care program in the country, Medicaid provides an essential safety net for women and mothers in the U.S. The program covers 17% of non-elderly women nationwide, including 41% of low-income women, and 36% of single mothers, and nearly half of all births. Extending postpartum Medicaid coverage for new moms to one year after delivery has the potential to help a total of at least 200,000 low-income uninsured mothers gain health care coverage.
Many state Medicaid programs and Medicaid managed care organizations are committed to addressing disparities in maternity care and improving maternal health outcomes through innovative programs that offer additional support such as nutritional assistance, increased access to home visiting programs and case management services, and new models of care such as coverage of doula services and supports. While significant strides have been made, there is still much work to do.
The Modern Medicaid Alliance includes national and regional organizations that represent patients, consumers, health care workers, children, older adults, people with disabilities, pregnant and postpartum women, and many of the country’s leading managed care organizations. As a partnership between Americans who value Medicaid and leading advocacy organizations, the Alliance works to educate policymakers and the public about the positive benefits and results of the Medicaid program. The Modern Medicaid Alliance remains committed to working with Congress to improve maternal health and ensure high-quality, affordable coverage for pregnant and postpartum women.
“The role of Medicaid in addressing the United States’ ongoing maternal health crisis cannot be understated. Millions of women rely on Medicaid for essential maternal health services, including family planning, prenatal services, and childbirth,” said Amy Haddad, Director of Public Policy and Government Affairs of the Association of Maternal & Child Health Programs. “With maternal mortality rates on the rise, continuing Medicaid and CHIP coverage for 12 months postpartum is critical to improving maternal health outcomes; addressing both routine and unforeseen needs; and to reduce the disproportionate threat to maternal health faced by women with lower incomes.”
“For many pregnant women and mothers, Medicaid provides vital access to high-quality, affordable maternal health care,” said Linda Goler Blount, President and CEO of Black Women’s Health Imperative. “Black mothers in particular face a unique set of challenges, suffering from higher rates of pregnancy-related complications and death. Bridging the gap and addressing health disparities will require urgent Congressional action to continue Medicaid and CHIP coverage for 365 days postpartum.”
“Women have significant medical needs through the first year after delivery, including higher rates of maternal mortality than during pregnancy or childbirth and postpartum depression which can take months to both appear and resolve,” said Gloria N. Eldridge, PhD, Divisional Vice President, Health Policy of Health Care Service Corporation (HCSC). “By allowing states to extend postpartum coverage to 365 days, Congress can significantly improve the health and well-being of both mothers and their children.”
“Infant and child health are deeply impacted by social determinants of health including discrimination, education, poverty, food insecurity, built environments, and community contexts as well as physical and mental health of mothers and caregivers,” said Jessica L. Peck, DNP, APRN, CPNP-PC, CNE, CNL, FAANP, President of the National Association of Pediatric Nurse Practitioners. “COVID-19 has widened the gap in these disparities and laid bare systemic inequities. In this time of great vulnerability, it is critical for Congress to act decisively to ensure accessible, affordable, quality care for mothers who desperately need support.”
“As an evidence-based community health program, Nurse-Family Partnership (NFP) knows that pregnant women benefit greatly by getting the care and support they need to have a healthy pregnancy,” said Sarah McGee, Chief Policy & Government Affairs Officer of Nurse-Family Partnership. “By ensuring access to registered nurses and other health care professionals, new moms can build the confidence and tools to provide a healthy start for their babies, and envision a life of stability and opportunity for success for both mom and child.”
“This is an unmitigated crisis that impacts babies and families across our country, and it has long-lasting impacts throughout all of our lives. If we want to truly address maternal mortality, we need to make the potential of every baby a national priority,” said Johanna Lister, Director of Policy for HealthySteps, a program of ZERO TO THREE. “This means high-quality care and services throughout the pregnancy and during the transition period after childbirth when mothers are adjusting to new parenthood and infants are forming critical connections with their caregivers. By supporting post-partum well-being, we give babies a strong foundation for a lifetime of healthy development, learning, and growth. Healthy families have healthy babies.”
About the Modern Medicaid Alliance: The Modern Medicaid Alliance is a partnership between Americans who value Medicaid and leading advocacy organizations. Our mission is to educate policymakers and the public about the benefits of Medicaid to the American people in terms of cost savings, health outcomes and social impact, and to highlight how Medicaid is innovating in the delivery of care – especially for America’s most vulnerable citizens – and accountability of the program.