Medi-Cal Extends Maternal Health Coverage

By Genoa Barrow | OBSERVER Senior Staff Writer

California mothers will have their health coverage for an extra year thanks to a recent extension of Medicaid and the Children’s Health Insurance Program (CHIP).

The new action extends coverage to 12 months postpartum for an additional 126,000 families in California and three other states: Florida, Kentucky and Oregon. The U.S. Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) representatives made the announcement.

“The first year after giving birth is a critical period – and families deserve the peace of mind knowing they will be able to access the health care coverage they need, without interruption,” said HHS Secretary Xavier Becerra. “This is a significant step forward in our efforts to improve maternal health and equity across the country.”

The expansion is made possible by a new state plan opportunity included in the American Rescue Plan. In California the extension will support 57,000 moms, officials say, the most of the four states. That provides critical peace of mind, said CMS administrator Chiquita Brooks-LaSure.

“Working together, we’re making a difference in countless lives, expanding access to health coverage to historic levels; advancing health equity, including using levers like the Medicare program to advance health equity; expanding postpartum coverage; and building back a stronger health care system,” Brooks-LaSure said.

“CMS now oversees the health care coverage of more than 140 million people. That’s an all-time record. It’s a vast responsibility and we are committed to develop new strategies to reach our goal of better health for all people.”

Having longer access to care will put communities, particularly those hard hit by health disparities, on a better course toward health and well-being, Brooks-LaSure said.

Medicaid covers 42% of all U.S. births. In 2021, President Joe Biden issued the first presidential proclamation marking Black Maternal Health Week, coupled with a set of initial actions to address the Black maternal health crisis.

According to an HHS report, 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.

Expansion is critical, said Jacey Cooper, chief deputy director of the California Department of Health Care Services and California’s Medicaid director.

“This new option offers dates and opportunity to provide care that can reduce pregnancy-related deaths and severe maternal morbidity, as well as improved continuity of care for chronic conditions such as diabetes, hypertension, cardiac conditions, substance use disorder and depression,” Cooper said.

“Without this extension, pregnant people risk losing Medicaid coverage as early as 60 days postpartum, even though the need for comprehensive care can extend well beyond those early weeks.”

Cooper said progress as Medicare and Medicaid enrollment have hit record levels has been significant.

“Importantly, CMS also has increased enrollment in healthcare.gov states among Hispanic people [by about] 26% and Black people by 35%.”

In California, maternal health advocates championed Senate Bill 65 in 2021.

“We had previously expanded in state only the coverage of 12 months postpartum for individuals to cover mental health services,” Cooper shared. “This is full-scope coverage for 12 months postpartum, drawing down full federal funds and so we are really excited around making sure that all services are covered for individuals for 12 months and maximizing the federal opportunity here.”

World Health Organization data shows lower postpartum health outcomes for Black individuals in California.

“We have put forward some bold strategies of working with community-based organizations working with providers to significantly drive and close some of those disparities,” Cooper said.

“With this additional coverage, we do think that it will be a huge opportunity to ensure that we are addressing all of the various services needed, not just chronic-conditions services and coordination, which are critical, especially if you have a diabetic mom who needs services and support; but also any postpartum depression, substance use and/or .. intimate partner violence, which we have seen, and often we’re seeing at higher rates for Black individuals in California. We’re excited for this additional coverage to help us really address some of those disparities that we are seeing in California. “

South Carolina, Tennessee, Michigan, Louisiana, Virginia, New Jersey and Illinois already have extended Medicaid and CHIP coverage from 60 days to 12 months postpartum.

Genoa Barrow

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