There has been a conversation within several of West Virginia’s nonprofit organizations on how to address Maternal Morbidity. Obviously, no one wants to see unnecessary deaths if they can be prevented, especially if the reason is that the individual simply cannot afford their postpartum care and are therefore not receiving the healthcare they need. We might be lacking data around this topic, but according to the CDC, we do know that maternal deaths are happening up to a year postpartum. Extending Medicaid to cover postpartum care past the current 60 days would be a good starting point.
By extending coverage to a year, we can help treat and maintain the risk factors for possible postpartum conditions such as diabetes, hypertension, depression, and gastrointestinal issues. Many of these issues last longer and need treated longer than the typical 60 days that Medicaid covers currently in West Virginia for Postpartum Care.
This conversation came up again at our West Virginia Kids’ Health Partnership Meeting on Thursday as we had the pleasure of hearing from Dr. Martha Carter, an independent consultant with the Medicaid and Chip Payment Access Commission. Dr. Carter shared with us MACPAC’s recommendations for postpartum coverage, which were:
- “Congress should extend the postpartum coverage period for individuals who were eligible and enrolled in the State Children’s Health Insurance Program (CHIP) while pregnant (if the state provides such coverage) to a full year of coverage, regardless of changes in income.”
- “Congress should require states to provide full Medicaid benefits to individuals enrolled in all pregnancy-related pathways.”
As someone who practiced as a certified nurse-midwife for 20 years, Dr. Carter shared how much she values the midwife system and feels we could better incorporate it to help prevent maternal morbidity. She stressed that other countries, such as the Netherlands, have successfully incorporated midwifery into their healthcare systems. Those countries also have much lower rates of maternal morbidity. Having access to that type of care here in the U.S. would be beneficial and has come up in come up in past conversations with the Kids’ Health Partnership.
Both Medicaid and CHIP extensions are expected to cost $1,500 per member covered. Although we do not have numbers of expected Medicaid postpartum members that will be covered. CHIP data shows that 91 postpartum pregnancies have been covered since the expansion went into effect on July 1, 2020. Currently, 176 women are enrolled in CHIP expansion for pregnant women making the cost reasonable. Especially when the provisions of the recently passed $1.9 trillion COVID relief package offer a path forward for postpartum coverage through the stimulus package by submitting the far simpler “State Plan Amendment” rather than through the “Demonstration Waiver” process.
Hopefully, extending Medicaid postpartum care to a year will be a step in the right direction to lowering Maternal Morbidity. With Medicaid covering close to half the births in West Virginia, we can see those numbers lower as individuals receive the care they need for as long as they need it.
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