Health care — moms can’t wait
Moms can’t wait — this has been our ongoing message for years as we urged Congress to extend Medicaid coverage for pregnant individuals to 12 months postpartum to help address the nation’s maternal mortality crisis. This crisis is grave and disproportionately impacts Black and Brown mothers.
The unprecedented COVID-19 pandemic is further exposing inequities faced by people of color and has a high likelihood of exacerbating poor maternal health outcomes for pregnant people across the country. Recent data from the U.S. Centers for Disease Control and Prevention (CDC) suggest that pregnant people are at a significantly higher risk of severe outcomes, including death, from COVID-19 than non-pregnant people.
Last week, the House Committee on Energy and Commerce proposed fast tracking a bipartisan policy to extend Medicaid coverage to 12 months after the end of pregnancy as part of the next COVID-19 relief package. This legislation would streamline the process for states to implement a policy that is foundational to their ongoing efforts to end preventable maternal deaths.
In 2020, the House of Representatives made significant progress in advancing similar legislation to incentivize states to implement this extension, passing it unanimously in September. Unfortunately, despite significant bipartisan support and continued attention on the maternal mortality crisis, this critical policy was not enacted. We are thrilled to see the House once again prioritizing this life-saving policy, this time with high probability of enactment via the fast track reconciliation process. Enactment of this policy could mean the difference between life and death.
According to the CDC, one in three pregnancy-related deaths occur between one week and one year after the end of pregnancy; this does not include deaths related to causes such as suicide and overdose, which are also drivers of maternal deaths in a growing number of states. Under the current statute, postpartum individuals covered by Medicaid lose their coverage 60 days after the end of pregnancy, leaving them uninsured and without access to care to treat a number of chronic conditions, including heart disease.
The Medicaid program covered 43 percent of U.S. births in 2018 and among demographic groups hit hardest by the maternal mortality crisis the number exceeds 60 percent. We must ensure that all individuals whose pregnancies are covered by Medicaid can keep their comprehensive coverage for at least 12 months postpartum. Doing so would save lives and is a critical step in addressing racial inequities in maternal health outcomes.
Extending Medicaid coverage beyond 60 days after giving birth is a leading recommendation of state maternal mortality review committees and has been endorsed by more than 275 national and state-based organizations. Maternal health experts in a diverse list of states, from Alabama to Minnesota to Texas have highlighted this policy as one solution among many to curb preventable maternal deaths.
The ongoing COVID-19 pandemic has underscored the need for Congress to act with urgency to complete its unfinished business and invest in this evidence-based policy that will not only improve maternal health outcomes but help eliminate existing racial health inequities. Providing women with access to the care they need is a major step toward that goal.
The maternal health crisis is an issue where policymakers on both sides of the aisle have and should continue to come together to work toward solutions. Extending coverage for new mothers ensures they can access the care they need during the first year of their baby’s life, improving both maternal and infant health. Our organizations know that this is only a first step and that more needs to be done to promote healthy outcomes for all mothers and babies.
We look forward to working with Congress to advance maternal health through additional legislation building on this critical extension of coverage. Maternal mortality impacts us all and policymakers must respond swiftly and decisively.
The time has come to meet the moment. Moms can’t wait.
Eva Chalas, MD, FACOG, FACS, is the president of the American College of Obstetricians and Gynecologists. Jacqueline W. Fincher, MD, MACP, is president of the American College of Physicians (ACP) and a primary care internist in Georgia. Lee Savio Beers, MD, FAAP, is the president of the American Academy of Pediatrics (AAP).
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