April 1 2022 – Per CMS, the Biden-Harris Administration is announcing that, beginning today, as many as 720,000 pregnant and postpartum people across the United States could be guaranteed Medicaid and Children’s Health Insurance Program (CHIP) coverage for a full 12 months after pregnancy thanks to the American Rescue Plan (ARP). Medicaid covers 42 percent of all births in the nation, and this new option for states to extend Medicaid and CHIP coverage marks the Biden-Harris Administration’s latest effort to address the nation’s crisis in pregnancy-related deaths and maternal morbidity by opening the door to postpartum care for hundreds of thousands of people.
In addition to related updates in the 2023 federal budget request, for example, in December 2021, Vice President Kamala Harris hosted the first-ever federal Maternal Health Day of Action, where she announced a call to action to both the public and private sectors to help improve health outcomes for parents and infants in the United States. Today’s announcements are a part of the Biden-Harris Administration’s continued response to that call to action to support safe pregnancies and childbirth, and reduce complications and mortality in the year following birth.
“Having postpartum care can be life-saving and lead to better long-term health outcomes for new parents and newborns,” said Health & Human Services (HHS) Secretary Xavier Becerra. “Thanks to President Biden’s American Rescue Plan, we are able to make it easier for states like Louisiana to give thousands more pregnant and postpartum people across the country access to high-quality, affordable coverage for the essential first year after birth. The Biden-Harris Administration has made maternal health and equity a priority, and we are working to ensure every parent has access to the care they and their child deserve.”
Louisiana, the first state CMS is approving to take advantage of this new state plan opportunity under the ARP, today began offering its enhanced coverage to an estimated 14,000 pregnant and postpartum people. CMS is also working with an additional nine states to extend postpartum coverage. In 2021, Illinois, New Jersey, and Virginia were the first states to use Medicaid demonstration authority to provide 12 months of continuous postpartum coverage for all Medicaid and CHIP enrollees. In addition, a number of other states have announced that they are working to extend Medicaid coverage to 12 months after pregnancy, and CMS looks forward to working those states. In order to receive federal funds and to ensure consistency with federal standards, including those set by the ARP, states must go through a formal process run by CMS.
“This is an historic step for states to partner with us to provide life-saving coverage for postpartum people—and meaningfully address the maternal health crisis. For too long, families have been left behind by a health care system that breaks connections to care when they are needed most,” said CMS Administrator Chiquita Brooks-LaSure. “Everyone deserves an opportunity to attain and maintain health. The American Rescue Plan created a pathway to connect pregnant people to vital health coverage through that first critical year after birth, and I urge every state to adopt this option to extend lifesaving postpartum coverage.”
Under existing requirements, many Medicaid and CHIP enrollees receive coverage through the end of the month in which their 60-day postpartum period ends. Maintaining Medicaid and CHIP coverage for a full year provides access to critical health care services during the first year after pregnancy, which can help to address persistent health disparities. One-third of maternal deaths occur between one week to a year after the end of pregnancy, and rates of maternal mortality are up to five times higher among Black and American Indian/Alaska Native people than their white peers.
Beginning April 1, 2022, the ARP’s new state plan option offers state Medicaid and CHIP agencies an opportunity to provide 12 months of continuous postpartum coverage. States choosing to extend postpartum coverage must elect this option in both Medicaid and their separate CHIP programs, if applicable, and submit required state plan amendments to CMS. The new ARP state plan option is currently limited to a five-year period that ends on March 31, 2027.
States like Louisiana that adopt the new extended postpartum coverage must provide coverage to all eligible individuals who were enrolled in Medicaid or CHIP while they were pregnant. This extended coverage period will last from the day the pregnancy ends through the end of the month in which their 12-month postpartum period ends.
The postpartum coverage option extends to current beneficiaries who are enrolled in Medicaid or CHIP while pregnant but are no longer pregnant when the state implements the ARP option, if the individual is within their 12-month postpartum period when their state implements the option. It also applies to individuals who were pregnant at some point during the three months prior to applying for Medicaid, if they met the eligibility requirements at that time.
Advancing this state plan option comes at a critical time for pregnant individuals and families, many of whom are relying on continued Medicaid and CHIP coverage for the ongoing care they need during the postpartum period. Continuity of coverage can help postpartum people manage chronic conditions, like hypertension and diabetes, that last well beyond the first 60 days postpartum, as well as provide access to behavioral health and other mental health care services.
Other states interested in learning about extending postpartum coverage through the ARP can contact their CMS state lead or consult the state health official letter CMS issued in December 2021.