California, Kentucky, Oregon, Florida Announce Postpartum Medicaid Expansion

CMS representatives announced Wednesday the expansion of Medicaid and Children’s Health Insurance Program (CHIP) coverage for postpartum care to 12 months in California, Kentucky, Oregon and Florida.

The move will provide coverage for an additional 126,000 families across the 4 states and serves to improve racial and economic disparities in maternal morbidity and mortality seen across the country.

In America, women die in childbirth at a higher rate than in any other developed country, while non-Hispanic Black women are more than 3 times more likely to have a maternal death than White women.

Over half of pregnancy-related deaths occur after the birth of the child, or in the postpartum period, while any death within 1 year of the end of pregnancy is considered a pregnancy-related death. Approximately 700 pregnancy-related deaths occur annually and two-thirds of these are considered to be preventable.

Of the 4 states announced in this new initiative, Florida is the only one that has not adopted Medicaid expansion under the 2010 Affordable Care Act.

Medicaid covers over 42% of births in the United States but might only extended coverage for a maximum of 60 days postpartum. A total of 140 million Americans are covered by both Medicaid and Medicare.

The 12-month extension opportunity is due to flexibilities put in place by President Biden’s American Rescue Plan.

The postpartum period is crucial in ensuring optimal health for the child and mother as 19% of maternal deaths occur within 1 week of the birth and are largely attributed to severe bleeding, high blood pressure, and infection. Women can also experience postpartum depression and suicidality following birth.

“As a mom, I know how critical these months after birth are and how important it is to have peace of mind of health coverage,” said CMS Administrator Chiquita Brooks-LaSure during the announcement.

“This new option offers states an opportunity to provide care that can reduce pregnancy-related deaths and severe maternal morbidity as well as improved continuity of care for chronic conditions such as diabetes, hypertension, cardiac conditions, substance use disorder and depression.”

Representatives from the 4 states outlined how they plan to advertise this new coverage period through working with non-profit groups, constituent outreach, and stakeholder engagement.

Other states have adopted similar postpartum expansions through the American Rescue Plan, and CMS continues to encourage all 50 states to do so, Brooks-LaSure said. Those with frameworks already in place include Michigan, Virginia, New Jersey, Illinois, Tennessee and South Carolina, among others.