Photo: Jose Luis Pelaez Inc/Getty Images
Beginning late last week, the Biden Administration extended postpartum healthcare coverage to as many as 720,000 pregnant and postpartum people across the U.S., who are now assured Medicaid and Children’s Health Insurance Program (CHIP) coverage for a full 12 months after pregnancy.
The coverage has been expanded due in part to the American Rescue Plan, which included an option for states to offer 12 months of postpartum Medicaid eligibility – a significant extension from the current requirement of 60 days.
According to the Department of Health and Human Services, Medicaid covers 42% of all births in the U.S.
The shift occurs mere months after the first-ever federal Maternal Health Day of Action in December 2021, at which Vice President Kamala Harris announced a call to action to both the public and private sectors to help improve health outcomes for parents and infants in the U.S.
The Centers for Medicare and Medicaid Services approved Louisiana as the first state able to take advantage of the coverage extension, and on Friday began offering it to an estimated 14,000 pregnant and postpartum people. CMS is also working with an additional nine states to extend this coverage.
WHAT’S THE IMPACT
In 2021, Illinois, New Jersey and Virginia were the first states to use Medicaid demonstration authority to provide 12 months of continuous postpartum coverage for all Medicaid and CHIP enrollees. A number of other states plan to follow suit, said HHS.
In order to receive federal funds and to 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 currently limited to a five-year period that ends on 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.
THE LARGER TREND
HHS, under the Biden Administration, has taken a number of steps meant to strengthen access to reproductive services. For instance, HHS issued a new final rule for Title X, the nation’s family planning program, to ensure access to affordable family planning services.
It also announced $6.6 million through Title X to address the demand for family planning services where restrictive laws and policies have impacted reproductive health access, or in states where there is a lack of or limited Title X access. In addition, the agency advanced its maternal health priorities, including expanding access to postpartum Medicaid coverage, rural healthcare services, and implicit bias training.
On top of that, HHS has issued guidance on both nondiscrimination requirements of the Church Amendments protecting healthcare providers through its Office for Civil Rights, and providers’ legal obligations and protections under the Emergency Medical Treatment and Labor Act, through the Centers for Medicare and Medicaid Services, to provide medical treatment to a pregnant patient who presents to the emergency department regardless of conflicting state laws or mandates that might seek to prevent such treatment.
Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com