In accordance with state law passed last year, Colorado expanded postpartum coverage for Medicaid and Child Health Plan Plus (CHP+) members from 60 days to 12 months on July 1st.
The expanded coverage is part of the new state plan option offered by the federal government under the American Rescue Plan Act of 2021 and impacts the approximate 25,000 live births that are paid for by Medicaid annually in Colorado.
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Enrollment in Colorado Medicaid and CHP+ is at an all-time high, reaching more than 1.7 million people earlier this year—a 118% increase since the end of 2013.
The growth has been attributed to the state’s decision to expand coverage for adults without dependent children and those with disruptions to employment and income in the early part of the pandemic.
Newborns were already qualified for 12 months of health coverage under Medicaid and CHP+ prior to the extension, so the expanded coverage primarily applies to the “whole” care women receive post-pregnancy, according to Colorado Access.
“[Mothers] have access to full Medicaid benefits. The care that they get is not isolated to just postpartum care,” said Gretchen Flanders McGinnis, Senior Vice President of Healthcare Systems and Accountable Care at Colorado Access. “If the mom develops another condition six months post delivery or needs additional pharmaceutical support or other specialty care for a condition that is new or predates her delivery, that’s all fully covered from the time that she was enrolled in Medicaid until 12 months after delivery. [That] includes full physical, behavioral, and pharmaceutical care.”
Data from the Colorado Department of Public Health & Environment indicate that women who are non-Hispanic Black and women on Medicaid/CHP+ have the highest rates of postpartum depression (PPD).
In 2019, Colorado Access members comprised 15.1% (9,481) of the state’s 62,875 live births. Statewide, there were 3,508 births to Black, non-Hispanic mothers, 1,415 of which were Colorado Access members. Because the organization covers a higher proportion of Black, non-Hispanic women, the organization is aware of the heightened risks of PPD in the population and says it is organized to better meet the specific health care needs of this population in the perinatal period.
National data show that significant and persistent disparities exist in pregnancy-related morbidity and mortality for women of color, including lower rates of engagement in postpartum follow-up care for conditions associated with morbidity and mortality.
Black and Indigenous individuals are up to 5 times more likely than white individuals to die from pregnancy-related complications and more likely to have a preventable death.
Federal guidance for expanding the coverage was based on research that showed half of pregnancy-related deaths occur in the 12-month postpartum period, and 12% occur after 6 weeks postpartum. The coverage extension recommendation was intended to push states to address the health inequities faced by women of color.
The Colorado Department of Health Care Policy and Financing (HCPF) launched an “Update Your Address” campaign earlier in the year to encourage members of Health First Colorado and Child Health Plan Plus (CHP+) to keep their contact information updated.
This is important because when the federal COVID-19 Public Health Emergency ends, members can receive the packet to renew their coverage and avoid losing their benefits by not filling out the necessary information.
Recent reports indicate that the Biden administration plans to further extend the federal COVID-19 Public Health Emergency past the July 15th deadline. The move would ensure that some 550,000 Colorado Medicaid members, who would otherwise be ineligible due to income thresholds, will continue to have coverage under Medicaid and CHP+.