Medicaid covers almost half of births in the U.S., and federal law requires that pregnancy-related Medicaid coverage last through 60 days postpartum. After that period, some may qualify for Medicaid through another pathway, but others may not qualify, particularly in non-expansion states. To help improve maternal health and coverage stability and to help address racial disparities in maternal health, a provision in the American Rescue Plan Act of 2021 gives states a new option to extend Medicaid postpartum coverage to 12 months via a state plan amendment (SPA). This new option takes effect on April 1, 2022 and is available to states for five years.

Under current law, states must provide continuous coverage to Medicaid enrollees through the public health emergency (PHE) period to be eligible for enhanced federal matching funds under the Families First Coronavirus Response Act. States seeking to implement extended postpartum coverage after the end of the PHE but prior to April 1, 2022 must do so through a section 1115 waiver or by using state funds.

This page tracks recent state actions to extend Medicaid postpartum coverage, including approved and pending 1115 waivers, legislation that will require the state to seek federal approval through a SPA or 1115 waiver, submitted and approved SPAs, and coverage financed solely with state funds.

Medicaid Postpartum Coverage Extensions: Approved and Pending State Action as of May 27, 2021

Medicaid Postpartum Coverage Extensions: Approved and Pending State Action as of May 27, 2021

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Medicaid Postpartum Coverage Extension Tracker