Mapping Our Maternal Health(r)evolution
SYSTEMWIDE TRANSFORMATION
What are states doing to improve maternal health?
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40 states and D.C. have extended Medicaid coverage from 60 days to 12 months postpartum
This extension ensures ongoing access to health services and is crucial for advancing health equity
11 states and D.C. now offer Medicaid coverage for doula services
Doulas are associated with lower rates of postpartum depression and provide person-centered care
12 states require maternal depression screening at well-child visits
42 states and D.C. cover postpartum depression treatment through Medicaid
31 states and D.C. have perinatal advisory councils
45 states and D.C. participate in the National Network of Perinatal Quality Collaboratives
Some states have implemented maternity care coordination and maternity medical home models that extend into the postpartum period
These models aim to provide more holistic and continuous care after childbirth
Some states, such as Connecticut, have expanded coverage for home visits and lactation services in the postpartum period
In today's political landscape, where strategies concerning women's health, particularly maternal health, are shaped by various influences, here is an overview of successes and pending legislation.
Postpartum Coverage Across States
The ACOG recommends insurance coverage policies are aligned to support a tailored approach to "fourth trimester" care. States have taken steps to advance legislation that would extend Medicaid eligibility until one year after delivery or when the pregnancy ends. Medicaid must cover pregnant individuals with incomes at or below 138% of the federal poverty level through 60 days postpartum.
Source: Rebecca Johnson et al., “State Policies to Improve Perinatal Health Outcomes,” map, Commonwealth Fund, last updated Nov. 20, 2023. https://doi.org/10.26099/x0x0-gt30
States Expand Postpartum Medicaid
In 2022, the U.S. Congress took a significant step to improve maternal health care by passing legislation that allows states to extend Medicaid coverage for new mothers from 60 days to a full year after giving birth. This extension can be implemented either through a state plan amendment or a Medicaid waiver.
As of now, 40 states plus the District of Columbia have adopted this extended coverage period. The majority of these - 37 states and D.C. - have done so via state plan amendments, while three states have obtained approval from the Centers for Medicare & Medicaid Services (CMS) through waivers.
Learn more about Doula Covered Services
As of now, 40 states plus the District of Columbia have adopted this extended coverage period. The majority of these - 37 states and D.C. - have done so via state plan amendments, while three states have obtained approval from the Centers for Medicare & Medicaid Services (CMS) through waivers.
Protection for the first 12-months
Long-term Support
The importance of this policy change cannot be overstated. By extending postpartum Medicaid coverage to a full year, states are ensuring that new mothers have continuous access to essential health services during a critical period. This extended coverage is a key factor in promoting both health and racial equity, as it helps reduce disparities in maternal and infant mortality rates.
The first year after childbirth is a time of significant physical and emotional changes for new mothers. Continuous access to healthcare during this period can address potential complications, support mental health, and provide necessary follow-up care. By extending coverage, states are acknowledging that the postpartum period doesn't end at 60 days and are taking concrete steps to support the long-term health of mothers and infants.
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The first year after childbirth is a time of significant physical and emotional changes for new mothers. Continuous access to healthcare during this period can address potential complications, support mental health, and provide necessary follow-up care. By extending coverage, states are acknowledging that the postpartum period doesn't end at 60 days and are taking concrete steps to support the long-term health of mothers and infants.
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