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ACOG Pleased Congress Passed Provisions in Omnibus to Improve Maternal Health Outcomes but Dismayed by Medicare Physician Payment Cuts

Washington, D.C.The following is a statement from Iffath Abbasi Hoskins, MD, FACOG, president of the American College of Obstetricians and Gynecologists (ACOG):
“ACOG is pleased to see Congress taking positive steps toward improving maternal health outcomes by prioritizing maternal mental health and creating a permanent option for states to provide 12 months of postpartum Medicaid and Children’s Health Insurance Program (CHIP) coverage through a simplified pathway in the FY 2023 omnibus appropriations bill. This critical policy, established under the American Rescue Plan Act, would have sunsetted in 2027 if Congress had not taken action.
“The maternal mortality rate in the United States is consistently one of the highest among industrialized nations, and recent data showed that the rate had continued to increase, exacerbated by the COVID-19 pandemic. The public health emergency has allowed people across the country to have continuous Medicaid and CHIP coverage after childbirth, even if their state legislators have chosen not to extend coverage. It is critical that postpartum individuals continue to receive coverage for a full year after pregnancy in order to help eliminate the many preventable deaths that occur during the postpartum period, as data have shown.
“While ACOG welcomes this provision as a step in the right direction, it still falls short of what is critically needed to save lives: mandatory, permanent, and comprehensive 12-month postpartum coverage under Medicaid and CHIP.
“Additionally, maternal mental health, a critical component of well-being during pregnancy and the postpartum period, is inextricably linked to the maternal mortality crisis. ACOG is pleased that the omnibus bill included the bipartisan Restoring Hope for Mental Health and Well-Being Act of 2022, which would support screening and increased access to treatment for maternal mental health and substance use disorders, among other things. Maternal mental health conditions affect an estimated one in five pregnant and postpartum individuals, and ACOG looks forward to the successful implementation of this important, lifesaving legislation.
“Lastly, while acknowledging that Congress partially mitigated the 4.5% cuts to physician payment under Medicare in 2023, ACOG is deeply disappointed that Congress is allowing our health care heroes to experience yet another cut. To help address the maternal health care crisis, physicians—and particularly obstetrician–gynecologists—have been tasked with improving quality of and access to care, and yet Medicare physician payment has dropped by 22% over the past two decades, when adjusted for inflation. These significant payment cuts have a negative impact on the mental well-being of physicians striving to practice in an increasingly unsustainable environment. The cuts also threaten overall access to care, as the current rates do not adequately cover the cost of care and further jeopardize the future of private practice. The proposed mitigation is inadequate, and ACOG will continue to advocate for financial stability for physicians through baseline increases reflecting inflation in practice costs and the elimination, replacement, or revision of budget neutrality requirements to allow for appropriate changes in reimbursement.”

The American College of Obstetricians and Gynecologists (ACOG) is the nation’s leading group of physicians providing evidence-based obstetric and gynecologic care. As a private, voluntary, nonprofit membership organization of more than 60,000 members, ACOG strongly advocates for equitable, exceptional, and respectful care for all women and people in need of obstetric and gynecologic care; maintains the highest standards of clinical practice and continuing education of its members; promotes patient education; and increases awareness among its members and the public of the changing issues facing patients and their families and communities.