A health care bill approved on the final day of the Missouri Legislature’s 2020 legislative session is designed to extend postpartum Medicaid coverage to women up to a year after giving birth.

House Bill 1682, an omnibus health care bill sponsored by Rep. David Wood, R-Versailles, included an amendment sponsored by Sen. Jill Schupp, D-St. Louis, that extends coverage for new moms in the event they suffer from postpartum depression or other mental health issues.

“This coverage will save lives and help keep families healthy and safe,” Schupp said. “I am grateful to have had bipartisan support for my legislation that will offer mental health coverage for low-income moms who need it.”

Schupp said the COVID-19 pandemic sheds light on the added stressors and concerns new mothers have following the delivery of the baby — especially if the mother suffers from postpartum depression.

“The social discomfort and economic insecurity may be added to postpartum depression,” Schupp said. “This will allow new mothers to get significant screenings and get help.”

The bill, which now awaits the governor’s signature, creates the Postpartum Depression Care Act and specifies “all hospitals and ambulatory surgical centers that provide labor and delivery services shall, prior to discharge following pregnancy, provide pregnant women and, if possible, new fathers and other family members information about postpartum depression, including its symptoms, treatment and available resources.”

To implement the extended coverage, state officials must submit a waiver application to the Centers for Medicare and Medicaid Services, which oversees Medicaid federally. The steps include public hearings and comment periods at both the state and federal levels.

State officials have previously applied for a waiver from the federal government to extend coverage for substance abuse disorder treatment for 12 months past the postpartum coverage period.

The federal comment period for the waiver closed at the end of March and is pending approval by the CMS staff.

“There’s a lot of steps,” Schupp said. “My hope is (it will be completed) within the next year. The additional stressors of the pandemic have made all of this much more important, so we need to move ahead as quickly as we can.”

Behind the amendment

This is just one of many issues related to children and families Schupp has championed during her time in the Missouri Senate.

She cites Missouri’s status as having the seventh-worst record for maternal mortality and having postpartum suicides as the second-leading cause for maternal deaths as reasons the state needs this policy change.

Approximately 1 in 7 women experience postpartum depression in the year after giving birth. Prior to the bill’s passage, Medicaid coverage for pregnant women in Missouri took care of women during their pregnancy and up to 60 days following birth, the minimum under federal law.

“We know the safety and health of mothers is important during the early days and months,” Schupp said. “A mother’s ability to bond (with their child) impacts the long haul for children and family.”

Schupp said postpartum depression is the most common complication following pregnancy, leaving new moms unable to deal with a myriad of issues.

“It has long-term ramifications,” Schupp said, adding children of mothers with this form of depression often suffer from depression or other adverse childhood issues — which places them behind their peers for success in school and in life.

“A healthy start in life can help determine a child’s future success and their ability to care for themselves,” Schupp said.

Changing policies

For Casey Hanson, director of outreach and engagement for Kids Win Missouri, the bill’s passage is monumental.

“We’ve spent time this year engaging with public health department employees, pediatricians and many other social service providers,” Hanson said. “Throughout the state, people agree we need to do more to support Missouri moms in the postpartum period.”

Hanson and others hope this will be the first of many steps taken by state officials to help new moms.

“This is the first step in a long march to make sure moms and babies have (access to health care),” Hanson said. “We know the best thing we can do is to provide support for babies and moms. This is progress in the right direction.”

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New bill designed to extend postpartum Medicaid coverage up to a year – Joplin Globe