CMS approves 12-month postpartum Medicaid/CHIP coverage in Georgia & Pennsylvania, joining 24 other states & DC!

via the Centers for Medicare & Medicaid Services:

Biden-Harris Administration Announces More than Half of All States Have Expanded Access to 12 Months of Medicaid and CHIP Postpartum Coverage

The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced that more than half of all states have expanded access to 12 months of Medicaid and Children’s Health Insurance Program (CHIP) coverage after pregnancy. Georgia and Pennsylvania are the 25th and 26th states to be approved for the extended coverage, made possible by provisions in the American Rescue Plan (ARP), signed into law by President Biden in March of 2021. This announcement marks critical progress in the implementation of the Biden-Harris Administration’s Maternal Health Blueprint, a comprehensive strategy aimed at improving maternal health, particularly in underserved communities.

As a result of this announcement, up to an additional 57,000 people in Georgia and Pennsylvania will now be eligible for Medicaid or CHIP for a full year after pregnancy. In total, an estimated 418,000 Americans across 26 states and the District of Columbia now have expanded access to postpartum coverage as a result of the ARP. If all states adopted this option, as many as a total of 720,000 people across the United States would be guaranteed Medicaid and CHIP coverage for 12 months after pregnancy.

The Biden-Harris Administration has made expanding access to high-quality, affordable health care a top priority – and because of the ARP and other Administration efforts, more people than ever before have health insurance coverage. Extending Medicaid and CHIP postpartum coverage is an important part of these efforts, and is a critical component of the Biden-Harris Administration’s Maternal Health Blueprint, which Vice President Harris announced on June 24, 2022.

“Last year, I launched a Call to Action for states to extend Medicaid coverage for postpartum women from 2 months to 12 months. Medicaid covers approximately 40 percent of all births nationwide, and one-fourth of pregnancy-related deaths occur between one and a half months and one year postpartum,” said Vice President Kamala Harris. “As of today, more than half of states have heeded this call, achieving an important milestone that will significantly impact women and families. Our Administration will keep fighting until every woman has access to expanded postpartum Medicaid coverage.” 

“To all remaining states: I urge you to join our efforts to support healthy mothers and babies and extend access to this critical care,” said HHS Secretary Xavier Becerra. “More than half the nation has extended postpartum coverage to a full year after pregnancy. This is a critical milestone in our effort to improve maternal health and equity across the country. President Biden and Vice President Kamala Harris have set a clear plan, and we are taking bold action to confront the maternal mortality and morbidity crisis.”

“I’m glad to announce that Georgia and Pennsylvania are extending coverage for a full year after pregnancy, and thrilled that we’ve surpassed the halfway mark of states that have extended this critical coverage,” said CMS Administrator Chiquita Brooks-LaSure. “The American Rescue Plan is serving as a foundation to support the health and wellbeing of women and families. Thanks to the Administration’s Maternal Health Blueprint, including CMS’ own Maternity Care Action Plan, maternal health improvements have become a priority to the majority nationwide.”

The extension of coverage was made possible by a new state plan authority established by the ARP, under which states may extend postpartum coverage in their Medicaid and CHIP programs from the current mandatory 60-day period to 12 months. Georgia and Pennsylvania are the most recent states to extend Medicaid and CHIP coverage for 12 months following pregnancy, joining California; Connecticut; Florida; Hawaii; Illinois; Indiana; Kansas; Kentucky; Louisiana; Maine; Maryland; Massachusetts; Michigan; Minnesota; New Jersey; New Mexico; North Carolina; Ohio; Oregon; South Carolina; Tennessee; Virginia; Washington; Washington, D.C.; and West Virginia. CMS continues to work with other states that have proposed adopting the ARP option to extend postpartum coverage to 12 months.

Medicaid covers 42% of all births in the nation and more than half of all children in the country. This new option for states to extend Medicaid and CHIP postpartum coverage is part of ongoing efforts through HHS and the Biden-Harris Administration to address disparities in maternal health outcomes by opening the door to postpartum care for hundreds of thousands of people. Extending Medicaid postpartum coverage is an important part of these efforts, as highlighted in the Biden-Harris Administration’s Blueprint for Addressing the Maternal Health Crisis and CMS’ recently released Maternity Care Action Plan. For more information on these and other efforts to advance connections to care for pregnant and postpartum individuals, consult this fact sheet.

As noted in a report published by the HHS Office of Assistant Secretary for Planning and Evaluation, one in three pregnancy-related deaths occur between one week and one year after childbirth. The postpartum period is critical for recovering from childbirth, addressing complications of delivery, ensuring mental health, managing infant care, and transitioning from obstetric to primary care.

CMS is also taking another step forward with its Maternity Care Action Plan by releasing data indicating if a hospital participated in a state or national program aimed at improving maternal and child health. This is the first in a series of updates being made to a new “Maternal Health” section of Hospital Compare. In the future, a “Birthing-Friendly” hospital designation will be used to identify hospitals that participate in a statewide or national perinatal quality improvement collaborative program and have implemented the recommended quality intervention.