CMS: More than 250,000 have gained access to postpartum coverage through Medicaid extensions

Photo: Jose Luis Pelaez Inc/Getty Images

About 253,000 parents have gained access to 12 months of postpartum coverage through Medicaid and Children’s Health Insurance Program extensions, according to data from the Department of Health and Human Services. It’s part of the current administration’s push to address maternal mortality and morbidity.

The Centers for Medicare and Medicaid Services approved actions in Maine, Minnesota, New Mexico and Washington D.C. to extend Medicaid and CHIP coverage for 12 months after pregnancy. 

This translates to Medicaid and CHIP coverage access for about 15,000 people annually across those states – including 2,000 in Maine; 7,000 in Minnesota; 5,000 in New Mexico; and 1,000 in Washington D.C. This coverage extension was facilitated in part by a new state plan opportunity established by the American Rescue Plan.

These states and the District of Columbia join California, Florida, Kentucky, Oregon, South Carolina, Tennessee, Michigan, Louisiana, Virginia, New Jersey and Illinois in extending Medicaid and CHIP coverage from 60 days to 12 months after pregnancy.

WHAT’S THE IMPACT

CMS continues to work to extend coverage for 12 months after pregnancy in other states that have submitted extension proposals, including Connecticut, Indiana, Kansas, Maryland, Massachusetts, North Carolina, Pennsylvania, Washington and West Virginia. 

If all states adopted this option, as many as 720,000 pregnant and postpartum people across the United States annually could be guaranteed Medicaid and CHIP coverage for 12 months after pregnancy, the agency said.

Medicaid covers about 42% of all births in the nation, according to federal statistics. More than half of pregnancy-related deaths in the U.S. occur in the 12-month postpartum period; 12% occur after six weeks postpartum.

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, the report said.

THE LARGER TREND

The current administration has backed a number of policies aimed at improving maternal health. Last year, President Biden issued the first-ever Presidential Proclamation marking Black Maternal Health Week, coupled with a set of initial actions to address the Black maternal health crisis. Vice President Kamala Harris hosted the first-ever White House Day of Action on maternal health.

In addition, HHS recently issued a new final rule for Title X, the nation’s family planning program, to ensure access to affordable family planning services.

The BIden White House initially expanded Medicaid and CHIP postpartum coverage in April, which was facilitated in part by the American Rescue Plan, which included an option for states to offer 12 months of postpartum Medicaid eligibility.

To receive federal funds and ensure consistency with federal standards, including those set by the ARP, states must go through a formal process run by CMS. States choosing to extend postpartum coverage must elect this option in both Medicaid and their separate CHIP programs, if applicable, and submit required state plan amendments to CMS. The new ARP state plan option is limited to a five-year period that ends March 31, 2027.

States like Louisiana that adopt the new extended postpartum coverage must provide coverage to all eligible individuals who were enrolled in Medicaid or CHIP while they were pregnant. This extended coverage period will last from the day the pregnancy ends through the end of the month in which their 12-month postpartum period ends.

The postpartum coverage option extends to current beneficiaries who are enrolled in Medicaid or CHIP while pregnant but are no longer pregnant when the state implements the ARP option – if they’re within the 12-month postpartum period when their state implements the option. It also applies to those who were pregnant at some point during the three months prior to applying for Medicaid if they met the eligibility requirements at that time.

ON THE RECORD

“Postpartum coverage not only improves health outcomes, but also saves lives,” said HHS Secretary Xavier Becerra. “Thanks to the American Rescue Plan, new parents will now have access to the ongoing care they need during the most crucial time after giving birth.
 

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com