In a series of posts, Myers and Stauffer will highlight parts of the American Rescue Plan Act of 2021 that can have tremendous impact on delivery and financing of services by state health and human services programs.
We first focus on the opportunities for states that support health coverage for women. The American Rescue Plan includes a provision that permits a five-year state plan option which would provide full health coverage for women enrolled in Medicaid for 12 months after the birth of a child (expanding the current eligibility period of 60 days). The provision lasts five years following the year after the bill was enacted thus expiring May 31, 2027. States who chose to include this option would want to do so quickly in order to take advantage of the full five year period.
This provision can address the steady increase in pregnancy related deaths over the past 20 years that the CDC has reported: in 1987, pregnancy related deaths were 7.2 per 100,000, a number that grew to 17.3 deaths per 100,000 in 2017. There are a number of causes associated with these deaths; however the leading cause continues to be heart muscle disease (cardiomyopathy) which can occur as late as one year after the birth. Unlike other causes such as blood clots, infection, and postpartum bleeding that can occur immediately following the birth, cardiomyopathy can occur after the current 60-day eligibility period ends. In total, 52% of deaths occur after the birth in the “post-pregnancy” phase. Expanded coverage provides an opportunity for states working to reduce maternal mortality rates by providing an option for extended coverage and access to life saving health care.
This provision does not address the critical phase of pre-natal care, but is an option that can build upon existing maternal health programs as well as other services offered in Medicaid programs through managed care or case management programs designed to support the needs of women. States may wish to look at their entire service array for women and examine the best way to leverage existing programs and services as well as gaps where Medicaid funding could be appropriately leveraged to enhance existing programs and potentially free up funding to provide care not currently covered.
For more information about maternal mortality and support for state programs, the CDC has resources available at https://www.cdc.gov/reproductivehealth/maternal-mortality/index.html. If you would like more information to implement and leverage Medicaid or other health and human services programs please contact Myers and Stauffer.
Contact the Contributors:
|Julia Kotchevar, MA
Health Care Senior Manager