New Mothers Now Receive 12 Months of Postpartum Medicaid Coverage

Over the past year, we have reported on Pennsylvania’s plan to expand postpartum Medicaid coverage from 60 days to 12 months, an expansion made possible by the American Rescue Plan. On April 1, 2022, the postpartum Medicaid expansion took effect. Now, new mothers receive 12 full months of Medicaid coverage following the birth of a child.

In a Bulletin released last month, the Department of Human Services indicated this expansion will “help beneficiaries maintain relationships with care providers, reduce pregnancy-associated deaths and racial disparities for pregnancy-associated deaths, improve maternal-child health outcomes and improve the health and wellbeing of pregnant beneficiaries as well as postpartum mothers and their children.”

Given the continuous coverage protections in place by virtue of the public health emergency (PHE), the expansion will only immediately benefit certain lawfully present immigrants. Prior to April 1, caseworkers were required to close the case after 60 days, despite the ongoing PHE. Now, caseworkers must allow these individuals to stay on Medicaid for 12 months. While the expansion has taken effect, advocacy with the County Assistance Office (CAO) may be needed during these initial months of implementation to ensure that all new mothers continue receiving Medicaid beyond the traditional 60-day postpartum period.

The importance of keeping new mothers on Medicaid longer cannot be overstated. In Pennsylvania, Medicaid covers 3 in 10 births; more than the national average. Pennsylvania’s Department of Health released a report last year analyzing 457 deaths determined to be pregnancy-associated deaths from 2013 to 2018. A pregnancy-associated death is defined as one that occurs while pregnant or within one year of the end of the pregnancy. The Department of Health’s report indicated Medicaid was the primary payer in Pennsylvania in about 53% of pregnancy-associated deaths, and nearly 60% of all pregnancy-associated deaths occurred between six weeks and one year after giving birth.

Pennsylvania also follows national trends of higher maternal mortality among Black women. White, non-Hispanic women accounted for 70% of the births in Pennsylvania between 2013 and 2018 and represented 65% of pregnancy-associated deaths during this period. However, non-Hispanic Black women accounted for only 14% of the births in Pennsylvania between 2013 and 2018, and yet represented 23% of the pregnancy-associated deaths during this period. The much-needed expansion of Medicaid coverage will allow women to obtain both the physical and mental health services that are so critical to a healthy postpartum recovery. As the Department of Human Services notes in the above Bulletin:

“Coverage during an extended postpartum period gives providers opportunities to assess beneficiaries’ physical recovery from pregnancy and childbirth, and to screen for and provide care to address conditions that can lead to morbidity and mortality in the later postpartum period. Comprehensive postpartum care should address chronic health conditions (e.g., diabetes or hypertension), mental health and psychological well-being (e.g., postpartum depression, interpersonal violence), and family planning (e.g., contraceptive counseling). Postpartum visits are also a time for providers to counsel beneficiaries on nutrition, breastfeeding, tobacco and other drug use, and other preventive health issues that affect both the postpartum beneficiary’s longer-term health and that of their infant.”