Almost half of the births in the United States are to mothers on Medicaid, the public insurance plan for low-income people. But these mothers are summarily shoved out of the program just six weeks after giving birth, a particularly cruel aspect of a particularly cruel system that contributes to the maternal mortality crisis. But it’s one that the American Rescue Plan aims to correct, if imperfectly so.
On Monday, Illinois became the first state to take advantage of a provision in the recently passed COVID-19 relief law that gives states the option to extend eligibility to a full year after birth, 46 weeks longer than the status quo currently allows.
Why does the Medicaid expansion matter?
As The 19th points out, those 46 weeks make a huge difference. Most moms don’t go to their first postpartum checkup until six weeks after giving birth. That means that they often find out about a potential problem in their 4th trimester just as they lose the ability to pay to treat it. That’s not great — and leads to a ton of unnecessary maternal death.
If more states join Illinois, this new rule could save many lives. Overall, a third of pregnancy deaths occur between 45 days (just past the six-week mark) and a year postpartum, otherwise known as the 4th trimester.
New moms in the U.S. die within a year of giving birth at twice the rate of moms in other wealthy nations.
The numbers are even grimmer for many women of color, as Black and Native American women are two to three times more likely than White, Latina, and Asian-American women to die within a year of childbirth.
Of course, Medicaid expansion isn’t a silver bullet that will fix the maternal mortality crisis in the U.S. or correct racial inequities in the healthcare system. But the more states that elect to extend Medicaid benefits for new mothers, the better.
The big question, then, is if other states will adopt the policy to help save maternal lives.
How many states will take advantage of the provision in the new law?
Twelve states are still refusing to expand Medicaid eligibility 12 years after the Affordable Care Act gave them the option, and if there’s a similar political divide on extending Medicaid to postpartum women it will blunt the impact of the new provision and deepen the divide among the states on birth-related outcomes.
The federal government pays for the bulk of the new provision but the states are responsible for some funding, which might serve as an excuse for some state officials to decline to expand health insurance to some of their neediest citizens.