Lawmakers in several conservative-led states — including Montana, Wyoming, Missouri, and Mississippi — are expected to consider proposals to provide a year of continuous health coverage to new mothers enrolled in Medicaid.
Medicaid beneficiaries nationwide are guaranteed continuous postpartum coverage during the ongoing COVID-19 public health emergency. But momentum has been building for states to extend the default 60-day required coverage period ahead of the emergency’s eventual end.
Approximately 42% of births nationwide are covered under Medicaid, the federal-state health insurance program for low-income people, and extending postpartum coverage aims to reduce the risk of pregnancy-related deaths and illnesses by ensuring that new mothers’ medical care isn’t interrupted.
The push comes as a provision in the American Rescue Plan Act makes extending postpartum Medicaid coverage easier because states no longer need to apply for a waiver. A renewed focus on maternal health amid high U.S. maternal mortality rates also is driving the proposals, as is the expectation that more women will need postpartum care as state abortion bans proliferate in the wake of the U.S. Supreme Court’s decision to eliminate federal protections.
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Thirty-five states and Washington, D.C., have already extended, or plan to extend, postpartum eligibility in their Medicaid programs. That number includes Texas and Wisconsin, which did not implement the ARPA provision but have proposed limited extensions of six months and 90 days, respectively.
The 15 states that limit postpartum Medicaid eligibility to 60 days are predominantly a swath of Republican-led states that stretch from the Mountain West to the South. But that could change when legislative sessions start in the new year.
In Montana, Republican Gov. Greg Gianforte and Department of Public Health and Human Services Director Charlie Brereton included 12-month postpartum eligibility in the governor’s proposed state budget. It would cost $9.2 million in federal and state funding over the next two years, according to the proposal, with the federal government covering nearly 70%.
Brereton considers the “extension of coverage for new mothers to be a pro-life, pro-family reform,” said Jon Ebelt, state health department spokesperson.
To become law, the proposal must be approved by state lawmakers once the legislative session begins in January. It has already received enthusiastic support from the senior Democrat on the committee that oversees the health department’s budget.
“Continuous eligibility for women after they have a baby is really important,” said state Rep. Mary Caferro.
