States around the country are making it easier for new moms to keep Medicaid in the year after childbirth, a time when depression and other health problems can develop.<\/p>\n\n\n\n
But tight government budgets and the program\u2019s low reimbursement may ultimately limit this push or make it hard for women with extended coverage to find doctors.<\/p>\n\n\n\n
\u201cA lot of things have changed since the pandemic,\u201d said Venessa Aiken, a new mom in Orlando, Florida. \u201cA lot of places no longer take Medicaid or if they do, you have to wait like two months before you can be seen.\u201d<\/p>\n\n\n\n
Many women enroll in government-funded Medicaid health insurance when they become pregnant, because qualifying income levels are higher than for women who aren\u2019t pregnant. The federal government requires states to maintain that coverage for 60 days postpartum, or after the baby arrives. After that, moms in many states lose the coverage unless their income levels are extremely low.<\/p>\n\n\n\n
Since the spring, 23 states and Washington, D.C., have said they will extend that coverage for a full year postpartum. Several more states are planning to do so.<\/p>\n\n\n\n
These extensions will start helping people after the federal government\u2019s COVID-19 public health emergency ends because states are required to keep patients enrolled during the emergency. It currently will extend at least into early next year.<\/p>\n\n\n\n
The push to extend coverage has grown to include both conservative and liberal-leaning states. It also is endorsed by President Joe Biden\u2019s administration as a way to improve equality: Postpartum mortality rates can be much higher among Black and American-Indian or Alaskan Native populations.<\/p>\n\n\n\n
\u201cThere\u2019s no reason why we should stop before we have every particular mother and baby (covered),\u201d Health and Human Services Secretary Xavier Becerra told The Associated Press. \u201cWhy wouldn\u2019t you want to provide to a new mother and new baby a full year\u2019s peace of mind?\u201d<\/p>\n\n\n\n
The state and federally funded Medicaid program covers prenatal doctor visits for moms and about 42% of births in the U.S.<\/p>\n\n\n\n
Having that coverage eliminated some stress for Maureen Forman, who said she was already concerned about her pregnancy when she gave birth to her son last year.<\/p>\n\n\n\n
\u201cIt was really nice not to worry,\u201d the 41-year-old Bloomington, Indiana, resident said. \u201cI just knew it was all going to be covered. I wish other pregnant women had that same experience.\u201d<\/p>\n\n\n\n
Care providers and researchers say that coverage should extend well beyond 60 days after the baby arrives.<\/p>\n\n\n\n
They note that many new moms need more time to squeeze in doctor visits while they recover from childbirth and care for a newborn. Some also are juggling a return to work while doing this.<\/p>\n\n\n\n
A coverage extension \u201cmatches the reality of the postpartum period,\u201d said Usha Ranji of the non-profit Kaiser Family Foundation, which researches health care issues.<\/p>\n\n\n\n
Issues like postpartum depression can develop months later, and some mothers might have lingering health problems that need care. Some also may need continued substance abuse treatment.<\/p>\n\n\n\n
Those who lose coverage may not be able to afford another option like private insurance.<\/p>\n\n\n\n
The non-partisan Congressional Budget Office estimated last year that about 45% of women on Medicaid will become uninsured after the 60-day postpartum coverage period ends.<\/p>\n\n\n\n
While nearly half the states have expanded the coverage, health economist Joe Antos said he thinks others will hesitate to add the expense to their budgets.<\/p>\n\n\n\n
Mississippi lawmakers scuttled a bill earlier this year that would have extended postpartum coverage partly over concerns about expanding the program.<\/p>\n\n\n\n
The coverage extensions, which last five years, are backed partly by funding from the 2021 American Rescue Plan Act. States will have to pay some of the bill.<\/p>\n\n\n\n
If the economy slides into a recession, \u201cstate enthusiasm for further expansions will also drop off as their own budgets tighten up,\u201d said Antos, who\u2019s with the American Enterprise Institute.<\/p>\n\n\n\n
Extending the coverage does not automatically guarantee better care, because finding doctors can be difficult.<\/p>\n\n\n\n
Jennie Joseph says the idea of trying to get a referral to a mental health specialist for a Medicaid patient is \u201claughable.\u201d The Florida midwife said patients first have to find a doctor to provide that referral and then land a therapist who accepts Medicaid, which is even harder.<\/p>\n\n\n\n
Joseph is the founder of Commonsense Childbirth, a nonprofit that operates a birth center and clinic in central Florida. She said low Medicaid reimbursement rates and payment hassles are challenging for care providers. She said the government program pays her clinic less than half of what a commercial insurer would pay for a prenatal visit. Medicaid reimbursement for postpartum visits is even less, as little as $34.<\/p>\n\n\n\n
\u201cIt\u2019s all about trying to get your claim paid, and they are more readily denied than they are paid,\u201d she said. \u201cBecause of that, providers don\u2019t make postpartum appointments for these mothers.\u201d<\/p>\n\n\n\n
Aiken, the Orlando newborn mom, gave birth at Joseph\u2019s center in July. She has had a hard time getting a call back from her primary care doctor\u2019s office, and she\u2019s worried about getting a referral to a specialist.<\/p>\n\n\n\n
\u201cIt\u2019s pretty confusing,\u201d she said. \u201cWho do you turn to when you don\u2019t have a (primary care physician)?\u201d<\/p>\n\n\n\n
Becerra said he knows that doctor access must be improved. But he sees the coverage extensions as a step toward making things better.<\/p>\n\n\n\n
\u201cLet\u2019s get people through the door and let\u2019s continue to work to increase the number of quality caregivers who will be there to meet those folks,\u201d he said. \u201cBut today we have hundreds of thousands of women and babies who can\u2019t even walk through the door. “<\/p>\n","protected":false},"excerpt":{"rendered":"
The federal government requires states to maintain that coverage for 60 days postpartum. After that, moms in many states lose the coverage.<\/p>\n","protected":false},"author":7,"featured_media":74009,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_yoast_wpseo_meta-robots-noindex":"","_yoast_wpseo_meta-robots-nofollow":"","_yoast_wpseo_canonical":"","_acf":"","_yoast_wpseo_primary_category":9,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","_smg_distribution_targets":[]},"categories":[65,31,15,9],"tags":[],"coauthors":[5821],"class_list":["post-24581","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-budget","category-home","category-management","category-federal-oversight"],"acf":{"subheadline":"","legacy_arc_id":"PLRECOUZWVDLJPHJXRYDASFRHE","arc_canonical_url":"\/federal-oversight\/2022\/09\/05\/medicaid-extensions-for-new-moms-may-run-into-federal-spending-limits\/","remove_feature_photo":false,"is_sponsored":false,"subtype":"","redirect_url":"","disable_inline_ads":false,"native_logo_pretext":"Presented By:"},"yoast_head":"\n