Lawmakers in more than a handful of states have passed measures this legislative session to expand Medicaid postpartum care coverage for mothers from 60 days to 12 months.
This year, Montana, Mississippi, Missouri, South Dakota, Texas, Utah, Wyoming, and Alaska have joined dozens of states that have already implemented the expansion option under the American Rescue Plan (ARP) of 2021.
Mothers covered by Medicaid are guaranteed 60 days of postpartum coverage under federal law. The ARP option allows states to amend their state plans to extend the coverage to a full year post-birth. Louisiana was the first state to extend postpartum coverage under its state plan.
Maternal Mortality StatisticsMore than 4 out of 10 births in the United States are covered under Medicaid, according to the Centers for Disease Control and Prevention data for 2020 (pdf).
About 23 percent of pregnancy-related deaths occurred seven to 42 days postpartum, while 12 percent took place between one to six days. Another 13 percent of deaths occurred on the day of delivery. The remaining 21 percent occurred during pregnancy.
There were six main underlying causes of pregnancy-related deaths, according to MMRC.
Mental health conditions, hemorrhage, cardiac and coronary conditions, infections, thrombotic embolism, and cardiomyopathy accounted for more than 75 percent of pregnancy-related deaths from 2017 to 2019.
Of those deaths, nearly 85 percent were determined to be preventable, validating the importance of expanded postpartum care coverage for mothers.
State Medicaid AmendmentsIn recent years, lawmakers on both sides of the aisle have recognized the high maternal mortality rate in the United States, especially among non-Hispanic black women, according to the CDC.
"Whether you're conservative, liberal, or somewhere in between, people are really supportive of maternal health and helping moms and babies get a good start," Maggie Clark told KFF. Clark is the program director for Georgetown University’s Center for Children and Families.
Thirty-five states, including Washington D.C., currently participate in the extended postpartum care coverage.
Once a state approves an amendment to extend Medicaid postpartum care coverage to a year, it must submit the proposal to the federal government for approval to participate in the program.
States that Failed to Pass BillsArkansas, Idaho, and Wisconsin lawmakers failed to pass bills to extend Medicaid coverage for 12 months.
Maternal Mortality Continues to RiseThe number of maternal deaths increased to 1,205 in 2021, up from 8621 in 2020, according to National Center for Health Statistics. There were 754 maternal deaths in 2019.
Across the nation, the maternal death rate for black women was 69.9 deaths per 100,000 live births, 2.6 times the rate for white women.
And the report showed that maternal mortality significantly increases with age, with the rate being 6.8 times higher for women 40 and over compared to women under 25.