HHS Approves 12-month Extension of Postpartum Medicaid and CHIP Coverage in North Carolina

Announcement comes as CMS also celebrates all 50 states and D.C. providing dental coverage in Medicaid/CHIP for pregnant and postpartum individuals, part of the Biden-Harris Administration’s push for more comprehensive health care to support families, children, and communities in need.

Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), approved the extension of Medicaid and Children’s Health Insurance Program (CHIP) coverage for 12 months after pregnancy in North Carolina. As a result, up to an additional 28,000 people will now be eligible for Medicaid or CHIP for a full year after pregnancy in North Carolina. With today’s approval, in combination with previously approved state extensions, an estimated 361,000 Americans annually in 24 states and D.C. are eligible for 12 months of postpartum coverage. If all states adopted this option, as many as 720,000 people across the United States would be guaranteed Medicaid and CHIP coverage for 12 months after pregnancy.

The Biden-Harris Administration has made expanding access to high-quality, affordable health care a top priority – and because of the American Rescue Plan (ARP) and other Administration efforts, more people than ever before have health insurance coverage. Extending Medicaid postpartum coverage is an important part of these efforts.

In addition to today’s postpartum extension in North Carolina, the Biden-Harris Administration is also highlighting that, beginning in October 2022, all 50 states and D.C. will offer dental coverage for Medicaid enrollees who are pregnant and postpartum through at least 60 days after pregnancy. This change means that an even broader array of critical Medicaid benefits will be available during and after pregnancy.

“We are thrilled to have North Carolina join our efforts to support healthy parents and babies by offering critical coverage through the first full year after pregnancy,” said HHS Secretary Xavier Becerra. “The Biden-Harris Administration has made addressing the maternal health crisis an urgent priority, and actions like today’s extension in North Carolina are a key part of our work. We are continuing to do all we can to strengthen Medicaid and CHIP and ensure all families and children get the high-quality, affordable health care they deserve.”

“North Carolina joins a growing list of state partners choosing to prioritize health care coverage in the critical first year after pregnancy,” said CMS Administrator Chiquita Brooks-LaSure. “The American Rescue Plan serves as a foundation to support the health and wellbeing of postpartum women and families. Thanks to the Administration’s Maternal Health Blueprint, including CMS’ own Maternity Care Action Plan, we’re continuing to improve maternal health across the country.”

The Biden-Harris Administration has championed policies to improve maternal health and equity since the President and Vice President first took office. In April 2021, President Biden issued the first-ever Presidential Proclamation marking Black Maternal Health Week. In December 2021, Vice President Harris hosted the first-ever White House Maternal Health Day of Action, where she announced important commitments to address the maternal health crisis. The Vice President also issued a call to action to the private and public sectors to improve maternal health outcomes, where she urged states to extend Medicaid coverage for postpartum women from 2 months to 12 months, and announced guidance for how states can extend their coverage. Additionally, she convened a historic meeting with Cabinet secretaries and agency leaders to discuss the Administration’s whole-of-government approach to addressing maternal mortality and morbidity. Today’s announcement is part of HHS’ ongoing effort to support safe pregnancies and childbirth, eliminate pregnancy-related health disparities, and improve health outcomes for parents and infants across our country.

In June, the White House released the Biden-Harris Administration’s Blueprint for Addressing the Maternal Health Crisis, a whole-of-government approach to combatting maternal mortality and morbidity. For far too many people, complications related to pregnancy, childbirth, and the postpartum period can lead to devastating health outcomes and result in hundreds of deaths each year. This maternal health crisis is particularly devastating for Black and American Indian and Alaska Native people, and those in rural communities, who all experience maternal mortality and morbidity at significantly higher rates than their white and urban counterparts.

In July, CMS released its Maternity Care Action Plan to support the implementation of the Biden-Harris Administration’s Blueprint. The action plan includes postpartum coverage extensions through Medicaid and CHIP. It takes a holistic and coordinated approach across CMS to improve health outcomes and reduce disparities for people during pregnancy, childbirth, and the postpartum period. CMS’ implementation of the action plan will support the Biden-Harris Administration’s broad vision and call to action to improve maternal health.

Today’s extension of coverage 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. North Carolina is the most recent state 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; Ohio; Oregon; South Carolina; Tennessee; Virginia; Washington state; Washington, D.C.; and West Virginia. CMS continues to work with other states that have proposed adopting the ARP option to extend postpartum coverage to 12 months. For more information, consult the fact sheet available here.

Medicaid covers 42% of all births in the nation and more than half of all children in the country. This new option for states to extend Medicaid and CHIP postpartum coverage is part of ongoing efforts through HHS and the Biden-Harris Administration to address disparities in maternal health outcomes by opening the door to postpartum care for hundreds of thousands of people. Extending Medicaid postpartum coverage is an important part of these efforts, as highlighted in the Biden-Harris Administration’s Blueprint for Addressing the Maternal Health Crisis and CMS’ recently released Maternity Care Action Plan. For more information on these and other efforts to advance connections to care for pregnant and postpartum individuals, consult this fact sheet.

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 is critical for recovering from childbirth, addressing complications of delivery, ensuring mental health, managing infant care, and transitioning from obstetric to primary care.

Visit Medicaid.gov to learn more about the Medicaid and CHIP state plan amendment extensions of postpartum coverage in North Carolina.