Across the U.S., thousands of people lose Medicaid coverage at 60 days postpartum. The entire postpartum period is 12-months, however, and applies to anyone who has experienced pregnancy. Coverage is important for birthing parents but essential for those who may have lost a pregnancy or experienced high-risk complications and have specific medical needs. Ending coverage early puts people in danger of losing access to essential health care when they need it the most.
Ensuring coverage during the full perinatal period is what EverThrive Illinois has been working toward for over 30 years. EverThrive IL is proud to share our advocacy’s impact to create a community where all people have safe, affordable, accessible health care. EverThrive IL strategically identified an opportunity to advocate for a nation-wide change and seized it to take a collective step towards building a better Medicaid program.
MACPAC, the Medicaid and CHIP Payment and Access Commission, is a non-partisan legislative branch agency that makes recommendations to the states, members of the U.S. Congress, and the Secretary of the U.S. Department of Health and Human Services. Testimony from EverThrive IL and other health advocates urged MACPAC to recommend a 12 month-postpartum coverage mandate for Medicaid. This push for expansion was successful, and MACPAC made a historic recommendation for a nation-wide Medicaid expansion with a 100% federal match in funding.
Mandating twelve months of coverage for people in the postpartum period is the first step to ensuring people stay healthy after giving birth. Not only will a mandatory expansion provide life-saving coverage for parents, but insurance coverage of a parent is a predictor of insurance coverage and health outcomes of children. Children will have better outcomes and have healthier parents by their side.”
EverThrive IL’s comments to MACPAC on mandating 12-month postpartum Medicaid coverage.
MACPAC’s recommendation of a 100% federal match in funding requires no state dollars to extend coverage to individuals with Medicaid or CHIP coverage as state budgets are stretched due to the pandemic. This bold recommendation signals postpartum coverage is a nation-wide solution to the rising rate of maternal death and severe morbidity. Most importantly, it would extend this vital coverage to more people sooner because state legislatures won’t have to use state funding to implement the expansion.
The ongoing pandemic shows us that with federal support, states can expand access that save lives. The Families First Coronavirus Response Act directed states to provide continuous coverage to people enrolled in Medicaid. The emergency continuation includes people enrolled on the basis of being pregnant who would have otherwise lost coverage after 60 days and has provided life-saving health care during the pandemic.
Permanent Medicaid coverage extension to one year postpartum is already underway in Illinois. Public Act 101-0010 directed the Illinois Department of Healthcare and Family Services (HFS) to expand Medicaid coverage from 60 days to one year postpartum. EverThrive IL has worked with HFS for over a year to effectively implement this change. As of February 2021, HFS has not yet received the required approval from federal CMS. Additionally, disparities remain in access and outcomes for people who are undocumented and unable to receive Medicaid coverage. Both the proposed Illinois expansion and MACPAC recommendation leave out people who are undocumented, and EverThrive IL will continue urging the state to address this lapse and cover all birthing parents.
We applaud MACPAC’s decision to support this equitable policy change and encourage policy decision-makers to continue supporting innovative solutions. Health care is a human right, and we must consider ways to include all people, regardless of citizenship status, while improving Medicaid.
authored by:
Kelsie Landers, LMSW
Policy and Advocacy Director
Sarah Ferguson
Policy Intern
University of Illinois at Chicago – MSW ’21