The Case for Postpartum Medicaid Extension

Author: HMHBGA Staff

In Georgia, over half of births are covered by the state’s Pregnancy Medicaid program. Pregnancy Medicaid covers full medical services, including prenatal care, substance use treatment, and behavioral health, for women at or below 220% of the federal poverty line (FPL) – about $34,000 for a family of two and $52,000 for four. These services are critical for ensuring the health of the mother and baby throughout the perinatal period. Unfortunately, 60 days after a mother delivers their baby Medicaid coverage ends, leaving many new mothers without access to optimal postpartum care. In fact, among Georgia new mothers, about 76% under the 220% FPL no longer qualify for Medicaid 60 days after delivery.

Georgia is facing a maternal mortality crisis. Throughout the perinatal period, women are at risk of mortality and morbidity related to pregnancy. These risks do not disappear when a pregnancy ends. In Georgia, most pregnancy-related deaths occur in the postpartum period and two out of three pregnancy-related deaths are preventable. Additionally, Black mothers in Georgia are about three times more likely to die from pregnancy-related deaths compared to White mothers.

Georgia mothers are in need of continued care for one year following delivery to ensure medical and behavioral health needs are met. This is especially true for many mothers who may be receiving Medicaid coverage for the first time and may have untreated chronic conditions. For example, if cardiomyopathy (one of the leading causes of Georgia’s pregnancy-related deaths) is discovered during a women’s pregnancy, she will need continuous specialized care after she gives birth. However when her Medicaid coverage ends after 60 days, she is at risk for experiencing serious and potentially life-threatening complications without access to appropriate healthcare providers.

In addition to saving lives, the measure would also save on healthcare costs. We know that extending Pregnancy Medicaid will save money for Georgia hospitals, especially those in under-resourced areas that typically end up caring for women in crisis during the postpartum period after their Medicaid has lapsed. The Georgia Budget & Policy Institute (GBPI) conducted a budget analysis where they found it to be cost effective in providing care for physical and mental health conditions. For example, the Department of Behavioral Health and Developmental Disabilities could save funds with the ability to bill Medicaid for services related to postpartum depression and anxiety.

The Georgia Maternal Mortality Review Committee, the Georgia House Study Committee on Maternal Mortality, and the Georgia House Study Committee on Infant and Toddler Social and Emotional Health have all recommended the extension of postpartum Medicaid coverage from the current 60 days to a year postpartum to prevent pregnancy-related deaths. Georgia’s mothers are in need of critical care beyond 60 days to maintain optimal health for themselves and their children.

Currently, there are three bills in the Georgia General Assembly proposing to extend Pregnancy Medicaid coverage. House Bill 693 (Renitta Shannon, D-Decatur) and Senate Bill 324 (Jennifer Jordan, D-Atlanta) would extend Medicaid coverage to a year postpartum. House Bill 1114 (Sharon Cooper, R-Marietta) would allow the Department of Community Health to apply for a Waiver to extend Pregnancy Medicaid coverage to six months postpartum and is supported by House Speaker David Ralston (R-Blue Ridge). Efforts are also being made on the federal level with Senator Cory Booker’s MOMMIES Act (SB 1343), which would extend coverage to one year postpartum nationally. Healthy Mothers, Healthy Babies Coalition of Georgia and a number of organizations are continuing to urge legislators to fund the extension of Pregnancy Medicaid to one year postpartum. Download the one-pager in support of Pregnancy Medicaid extension here.