Despite maternal mortality decreasing globally over the past two decades, the United States remains the only developed country where maternal mortality has increased. Pennsylvania is not immune to these statistics. Earlier this year, the Wolf Administration announced its plan to expand the Medicaid postpartum coverage period from 60 days to 12 months. Recently, the Department of Human Services, which runs Pennyslvania's Medicaid program, reaffirmed its intent to move forward with the expansion effective April 1, 2022, the earliest date states are allowed to adopt this option under the American Rescue Plan (ARP).
Current Medicaid policy only allows a mother 60 days of post-partum insurance coverage following the birth of a child. Modern medicine shows 60 days is not enough time to ensure a full and healthy recovery following childbirth. “Ending pregnancy-related coverage . . . just 60 days after birth risks mothers going without necessary and potentially life-saving care,” said Department of Human Services Acting Secretary Meg Snead. “The first year post-birth is a critical time for the entire family’s health and well-being and this expansion will help mothers maintain relationships with care providers undisrupted.” The expansion of Medicaid postpartum coverage is critical to ensuring the health and welfare of mothers after childbirth, particularly Black and brown women, who are disproportionately impacted by maternal mortality. States that have already expanded Medicaid postpartum coverage report an increase in postpartum care visits, continuity in coverage, and enhanced engagement of individuals in health care.
In Pennsylvania, Medicaid covers about 3 in 10 births. Pennsylvania’s Department of Health released a report last year analyzing 457 pregnancy-associated deaths in Pennsylvania from 2013 to 2018. The report defines a pregnancy-associated death as one that occurred while the mother was pregnant or within one year of the end of the pregnancy. The Department of Health report indicated Pennsylvania Medicaid was the primary insurance payer in about 53% of pregnancy-associated deaths. The report further shows that nearly 60% of all pregnancy-associated deaths from 2013 to 2018 occurred between six weeks and 12 months after giving birth, thus falling largely outside the 60-day coverage period allowed under current Medicaid policy. Pennsylvania also follows the national trend of higher maternal mortality rates among Black women. White, non-Hispanic, women accounted for 70% of births in Pennsylvania between 2013 and 2018 and represented 65% of pregnancy-associated deaths during this time. Non-Hispanic Black women accounted for only 14% of the births in Pennsylvania between 2013 and 2018, yet represented 23% of pregnancy-associated deaths during this time. The expansion of Medicaid coverage to 12 months postpartum will allow women to obtain the physical and mental health services they need to have a healthy post-birth recovery.
The Department of Human Services will submit to the federal government a formal declaration of intent to expand the Medicaid postpartum coverage period as soon as the Centers for Medicare and Medicaid Services (CMS) issues guidance to states on this option. PHLP is thrilled that Pennsylvania plans to take this important step towards protecting maternal health equity. We will continue to keep readers updated about this critical expansion of benefits in the coming months.