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The U.S. Department of Health and Human Services, through the Centers for Medicare and Medicaid Services, has approved the extension of Medicaid and Children’s Health Insurance Program (CHIP) coverage for 12 months after pregnancy in three new states: Hawaii, Maryland and Ohio.

CMS expects that up to an additional 34,000 people annually – including 2,000 in Hawaii, 11,000 in Maryland and 21,000 in Ohio – will now be eligible for Medicaid or Title XXI-funded Medicaid expansion CHIP coverage for a full year after pregnancy.

When combined with previously approved state extensions, an estimated 318,000 Americans annually in 21 states and Washington D.C. are eligible for such coverage. If all states adopted this option, said HHS, as many as 720,000 people across the U.S. annually would be guaranteed Medicaid and CHIP coverage for a year post-pregnancy.

This extension of coverage was made possible by a new state plan authority established by the American Rescue Plan, under which states may extend postpartum coverage in their Medicaid and CHIP programs from the current mandatory 60-day period to 12 months.

Hawaii, Maryland, and Ohio now join California; Connecticut; Florida; Illinois; Kansas; Kentucky; Louisiana; Maine; Massachusetts; Michigan; Minnesota; New Jersey; New Mexico; Oregon; South Carolina; Tennessee; Virginia; Washington state; and Washington D.C.


Improving maternal health and equity has been an ongoing concern for the current administration. In April 2021, President Biden issued the first-ever Presidential Proclamation marking Black Maternal Health Week. In December 2021, Vice President Kamala Harris hosted a White House Maternal Health Day of Action, at which she announced commitments to address the maternal health crisis. 

Harris 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 two months to 12 months and announced guidance for how states can extend their coverage.

In June, the White House released the Biden-Harris Administration’s Blueprint for Addressing the Maternal Health Crisis, a whole-of-government approach to combating maternal mortality and morbidity.


Extending Medicaid and CHIP coverage is part of CMS’ Maternity Care Action Plan, announced in July. CMS said it’s also working to expand its data collection efforts, build a better understanding of key demographic drivers of health to identify disparities in care or outcomes, and coordinate across programs to identify gaps and best practices.

CMS said it will also engage with states, providers and other stakeholders to improve maternal care among Medicaid, CHIP, Medicare and Health Insurance Marketplace enrollees, and with states and sister agencies to expand and improve access to the maternity care workforce, including midwives and community-based practitioners such as doulas and community health workers.

Also in July, HHS’ Office of the Assistant Secretary for Health announced it was investing $8.5 million in initiatives designed to reduce pregnancy-related deaths and complications that disproportionately impact minority populations and those living in rural areas. OASH announced 25 winners of the first phase of the HHS Racial Equity in Postpartum Care Challenge. American Indian/Alaska Native and Black women are two to three times more likely to die from a pregnancy-related cause than Caucasian women, the agency said.

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HHS approves 12-month postpartum Medicaid, CHIP extension in 3 states – Healthcare Finance News