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The COVID-19 pandemic could exacerbate the maternal mortality crisis. Urge your Members of Congress to extend Medicaid coverage. Act Now!

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The Issue

Individuals with pregnancy-related Medicaid coverage typically lose their benefits 60 days after the end of pregnancy. Our nation’s rate of maternal mortality is rising, and a growing body of evidence shows that many of these deaths, particularly from preventable causes such as overdose and suicide, occur after pregnancy-related Medicaid coverage ends. In West Virginia, for example, 62 percent of all maternal deaths from 2007-2013 occurred more than 60 days postpartum.

Extending Medicaid Coverage Can Help Eradicate Preventable Maternal Deaths

The United States is experiencing a maternal mortality crisis.

As the largest single payer of maternity care in the U.S., covering over 42 percent of births, Medicaid has a critical role to play in ensuring healthy moms and babies. One in three women experience a disruption in insurance coverage before, during, or after pregnancy, and nearly 60% of these perinatal insurance disruptions include a period of uninsurance. ACOG is taking action at the state and federal levels to ensure all individuals whose pregnancies are covered by Medicaid can keep their Medicaid coverage for at least one year postpartum, including coverage for such services as case management and outreach, substance use disorder treatment, and mental health screening and treatment.

Maternal Health Experts Agree

In addition to being endorsed by over 275 national and state-based organizations, extending Medicaid coverage beyond 60 days postpartum is a leading recommendation of state maternal mortality review committees (MMRCs) and state departments of health. Maternal health experts in Arizona, Georgia, Illinois, Iowa, Louisiana, Maryland, Texas, Utah, and Washington have each highlighted this policy as one solution among many to ending preventable maternal deaths. 

State Advocacy

Extending postpartum Medicaid coverage can be achieved through various pathways. At present, states have the opportunity to extend coverage with legislative action through a bill, executive action in a governor’s budget, or regulatory action by submitting a Section 1115 waiver request to the federal Centers for Medicare and Medicaid Services (CMS). The interactive map below captures state activity related to this policy. 

 

 

Methodology & COVID-19 Update: The information above is meant to identify state actions to achieve a postpartum coverage extension in Medicaid, including efforts that were stalled due to the COVID-19 pandemic. This information will be updated monthly. For more information on a particular state, or if you feel action in your state has been misrepresented, please email stateleg@acog.org and follow @ACOGaction.

 

Federal Advocacy

ACOG is a leading voice advocating to Congress and the Administration to extend Medicaid coverage to at least one year postpartum. In Congress, ACOG’s work has focused on enacting bipartisan legislation in the U.S. House of Representatives and U.S. Senate to support state efforts to extend postpartum coverage. With the Administration, ACOG advocates to CMS to encourage states to pursue this policy and to swiftly approve pending Section 1115 waiver requests.

ACOG Advocacy in Action

COVID-19 Update: Due to the COVID-19 pandemic, states are prohibited from kicking individuals off of the Medicaid program at 60 days postpartum. Instead, people whose pregnancies are covered by Medicaid are now able to receive continuous coverage through the end of the pandemic. ACOG emphatically supports this policy change and has asked the federal government to conduct research on the impacts of this coverage as well as to continue this coverage beyond the length of the COVID-19 pandemic. Learn more

COVID-19 Advocacy