Happy Monday, and thanks for reading. Your researcher McKenzie is in for Rachel with today’s top.

Today’s edition: President Biden declared the coronavirus pandemic “over.” Sen. Lindsey Graham is standing by his abortion ban amid mixed Republican support. But first …

Two leading Democrats want to make 12 months of Medicaid postpartum coverage permanent and nationwide

Half the states have taken advantage of a vehicle created in President Biden’s coronavirus relief bill making it easier to extend Medicaid benefits to a full year after birth for low-income new mothers.

And while the option has had notable success, there’s one key caveat: Congress only authorized the pathway for five years. Meaning that without additional action by lawmakers, extra postpartum coverage in these states will expire on April 1, 2027.

Now, Democrats trying to stave off a major headache are pushing to make the extensions permanent in a must-pass legislative vehicle at the end of the year, several sources on Capitol Hill told The Health 202.   

Inside Congress

Fifteen states have yet to voluntarily extend their postpartum benefits. If all states adopted the option, Health and Human Services (HHS) estimates that as many as 720,000 women across the United States annually would be guaranteed Medicaid and Children’s Health Insurance Program (CHIP) coverage for a full year after pregnancy — a shift that advocates argue could help the nation’s maternal mortality rate.  

Democrats had hoped to include provisions to permanently require all state Medicaid programs to provide 12 months of coverage postpartum in their Build Back Better spending package, but the policies were ultimately nixed from their sweeping Inflation Reduction Act.

Now, lawmakers say they aren’t ditching the effort. Party leaders, including Senate Majority Whip Richard J. Durbin (D-Ill.) and House Energy and Commerce Chair Frank Pallone Jr. (D-N.Y.), are actively seeking a legislative vehicle to attach provisions that would mandate all states permanently extend their state Medicaid plans to provide 12 months of postpartum care, according to sources familiar with the situation.

One main piece of legislation is on the table: an omnibus appropriations package for the upcoming fiscal year that Democrats are hoping to squeak through before the new Congress is seated — when control over one or both chambers could change.

Including this measure is very much under active discussion among leadership,” a spokesperson for Durbin told The Health 202. Whether Republicans would support attaching the policy to a year-end spending bill that would need their votes to pass remains to be seen, but GOP lawmakers have co-sponsored legislation to extend coverage to a full year after birth in the past.

Champions of the 12-month extension are optimistic about reintroducing provisions to make it a permanent requirement in light of the Supreme Court’s decision overturning the federal right to abortion.

“I think we’re going to get bipartisan support,” said Rep. Robin L. Kelly (D-Ill), chair of the Congressional Black Caucus Health Braintrust, for which the issue is a top priority. “Republicans are going to be in trouble come November because of that decision, and we’re hoping that will get us more allies.”

More from Kelly: 

State of play

The Medicaid program currently finances about 4 in 10 births across the United States. Federal law requires states to provide pregnancy-related Medicaid benefits 60 days postpartum for the nation’s lowest income new mothers. But a growing body of evidence shows that many pregnancy-related deaths occur after that coverage ends.

Democrats believe extending Medicaid benefits will help improve both maternal and infant outcomes in the year after birth, particularly in Black and Native American communities. The Biden administration even made it a key pillar in its Blueprint for Addressing the Maternal Health Crisis.

States have several pathways through which they can extend coverage to a full year after birth, including by using state funds or submitting a Section 1115 waiver request to the Centers for Medicare and Medicaid Services, as Illinois, New Jersey and Virginia did in 2021 and Florida elected to do so earlier this year.  

The number of states implementing 12-month extensions skyrocketed, though, following the rollout of the state plan amendment, a new option created in the American Rescue Plan. That vehicle makes it easier for states to extend their benefits, and it went into effect on April 1, 2022.

Since then, CMS has approved state plan amendments (SPAs) from 25 states and D.C. An additional eight states have submitted SPAs to do the same and are waiting on approval from federal regulators. Two states, Texas and Wisconsin, have proposed to extend their state Medicaid postpartum plan but only up to six months and 90 days respectively, according to data tracked by the Kaiser Family Foundation (KFF).

It’s worth noting … 12 months of postpartum Medicaid coverage has been available in all 50 states ever since the covid-19 public health emergency began. In exchange for extra federal funding, states are required to provide continuous coverage to Medicaid enrollees throughout the duration of the public health emergency. Once the PHE ends, states that haven’t extended their postpartum coverage will be able to start removing mothers from Medicaid after 60 days following birth

“These 12-month coverage extensions will kick in once the public health emergency ends and states begin to resume normal operations,” said Jennifer Tolbert, director of state health reform at KFF.

Take a look at the state of Medicaid postpartum extension nationwide from KFF: 


Biden: ‘The pandemic is over’

President Biden declared the coronavirus pandemic “over” last night in a series of apparently unprepared remarks that reflect the growing sentiment that the virus’ threat has receded, even as hundreds of Americans continue to die from covid-19 each day, our colleague Dan Diamond reports.

“We still have a problem with covid. We’re still doing a lot of work on it … but the pandemic is over,” Biden said on CBS’s “60 Minutes.” “If you notice, no one’s wearing masks. Everybody seems to be in pretty good shape. And so I think it’s changing.”

The administration for months has maintained that the virus is on the retreat, citing the growing availability of vaccines, tests and treatments to fight it. But Biden’s comments that the pandemic is “over” came as a surprise to administration officials, according to two senior health officials who were not authorized to comment.

The bigger picture: Biden’s comments may complicate his administration’s efforts to secure additional funding from Congress to fight the virus. Republicans on Sunday night raised questions about why the Biden administration would renew its ongoing public health emergency for covid if the pandemic was over. That emergency declaration, which is set to expire next month but is often renewed, has allowed federal officials to pursue flexible solutions amid the pandemic, including rapidly authorizing new covid treatments and keeping many Americans covered by Medicaid, Dan writes. 

Listen to Biden’s remarks about the covid-19 pandemic below:

On the Hill

Graham defends national abortion ban despite mixed support from Republicans 

Sen. Lindsey Graham (R-S.C.) defended his proposal to restrict abortions nationally yesterday, despite wavering Republican support for the legislation ahead of the midterm elections.

“I am confident the American people would accept a national ban on abortions at 15 weeks, with exceptions for the life of the mother, rape and incest,” Graham told “Fox News Sunday” anchor Shannon Bream.

The bill, introduced last week, has sparked criticism from members of his own party, many of whom stand by the states’ rights argument adopted by Republicans — including Graham himself — after the Supreme Court overturned Roe v. Wade in June.

Sen. Mike Rounds (S.D.) is the latest Republican to distance himself from the national ban. He told CNN’s “State of the Union” anchor Jake Tapper yesterday that he doesn’t plan to vote for the legislation.

  • I don’t think any proposal today would be successful in the House and the Senate,” Rounds told Tapper. “I think a better approach probably will be to allow the states to work through this and to find the appropriate language on a state-by-state basis.”

More from Rounds:

Meanwhile in West Virginia …

Gov. Jim Justice (R) on Friday signed a law banning abortions at every stage of pregnancy with narrow exceptions for medical emergencies and for rape and incest, the Associated Press reports.

Lawmakers are holding several health-related hearings Wednesday: A Senate Appropriations subcommittee is holding a hearing on the Department of Veterans Affairs’ electronic health record modernization initiative; the Senate Veterans Affairs Committee will meet to discuss veterans’ timely access to care in the VA; and the House select subcommittee on the coronavirus crisis will convene to examine the pandemic’s impact on nursing homes.

Our Washington Post Live colleagues have a jam-packed week. Here’s what to watch:

Wednesday: Worta McCaskill-Stevens, director of the Community Oncology and Research Program at the National Cancer Institute, and Joan Lunden, journalist and advocate, on new approaches to cancer treatment.

Thursday: Care.com CEO Tim Allen, Wives and Girlfriends of Spinal Cord Injury co-founders Brooke Pagé and Elena Pauly, and Marshall Plan for Moms founder Reshma Saujani on the state of unpaid caregiving.

Friday: California’s Health and Human Services Secretary Mark Ghaly and Kizzmekia S. Corbett, assistant professor at the Harvard T.H. Chan School of Public Health, on health equity and the lessons of the covid-19 pandemic.

In other health news

  • On the move: Merith Basey will serve as executive director of the bipartisan advocacy organization Patients For Affordable Drugs and its sister organization Patients For Affordable Drugs Now.
  • About 400 demonstrators marched to the White House on Saturday to demand the government put forth a greater effort to promote public understanding of fentanyl, The Post’s Meryl Kornfield reports.
  • As abortion bans take effect across wide swaths of the South, public schools in Texas will begin teaching about contraceptives, instituting the first revision to the state’s sexual health education curriculum in more than 20 years, NBC News reports.
  • Planned Parenthood Federation of America is launching a series of billboards today in five states where abortion rights are protected to highlight where patients can access the procedure in a post-Roe America, the nonprofit organization told the Health 202. 

Health reads

Covid shots for young kids arrived in June. Few have received them. (By Sabrina Malhi | The Washington Post)

Private Equity Sees the Billions in Eye Care as Firms Target High-Profit Procedures (By Lauren Weber | Kaiser Health News)

Amid threats, W.Va.’s only Black female lawmaker stood up for abortion (By Emmanuel Felton | The Washington Post)

Sugar rush

Thanks for reading! See y’all tomorrow.


Go to Source

Analysis | Democrats are pushing to avoid a Medicaid cliff for new moms – The Washington Post