CMS approved an extension of Michigan’s Medicaid and CHIP coverage for 12 months postpartum last month. It originally covered postpartum mothers up to 60 days after birth.
Laura Appel, Executive Vice President of Government Relations and Public Policy at the Michigan Health and Hospital Association (MHA), told State of Reform this extension will provide needed coverage to 35,000 pregnant and postpartum women who have many medical needs after 60 days postpartum. She said this will also improve health equity and access to behavioral health treatment in Michigan.
Stakeholders have worked on this proposal for some time in the state. Appel said the Senate Appropriations Subcommittee on Health and Human Services had a hearing on this issue for their FY 21 negotiations, and this extension was a part of Gov. Gretchen Whitmer’s Healthy Moms Health Babies proposal. However, the pandemic and CMS’ decision to halt Medicaid disenrollment due to the public health emergency halted the work.
“It feels counterintuitive to why health care coverage for women would end 60 days after they gave birth,” Appel said. “You would in no way expect coverage to end so quickly.”
Appel said there are many medical issues women can face after the first 60 days of postpartum coverage. She said 17% of pregnancy related maternal mortality in Michigan happens 43 days or more after birth. Of the Medicaid population, 76% of pregnancy related maternal mortality—between 2013 and 2017—happens 43 days or more after birth.
“So here we have an entire set of people who might have postpartum depression, they might have medical causes of death like cardiomyopathy, they might have substance use disorder, or other behavioral health problems,” Appel said. “In all cases, their coverage through Medicaid has expired at the time that these events that ultimately cause death occurred.”
Racial disparities and the advancement of health equity also played a key role in this extension, Appel said. She said African American women are three times more likely to die from pregnancy related causes than white women. With over half of all births covered by Medicaid in Michigan, extending coverage helps marginalized African American women access needed services.
“Just working on maternal mortality alone helps us get at health equity,” Appel said. “We’re getting at a problem that is not shared to any degree like it is for Black women and Native American women.”
This coverage extension was official as of April 1st, 2022.