12-month Medicaid postpartum extension approved in Maryland, Hawaii, Ohio


Nicole Pasia


An estimated 34,000 Medicaid beneficiaries in 3 states are now eligible for an extension of postpartum coverage up to 12 months. The U.S. Department of Health and Human Services (HHS), through CMS, approved the extension for Maryland, Hawaii, and Ohio this week. 


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The American Rescue Plan included a temporary option for states to extend Medicaid and Children’s Health Insurance Program (CHIP) postpartum coverage from the original period, which was 60 days. As of 2021, 7 states had approved or pending 1115 demonstrations to enact the postpartum coverage extension, according to the Office of Health Policy at the Assistant Secretary for Planning and Evaluation (ASPE). 

Advocates have long pushed to expand postpartum care beyond the initial 60 days. According to ASPE, 1 in 3 pregnancy-related deaths occur within the first year after childbirth, and postpartum individuals are at risk of disruptions in care if Medicaid coverage cuts off after 2 months. 

In Hawaii, ensuring the extension of postpartum coverage was a top priority for policy makers during the last legislative session. A total of $5.8 million in state and federal funds will support the extension to about 2,000 individuals in Hawaii. 

“Unfortunately, a lot of moms are dealing with postpartum depression,” Hawaii Rep. Linda Ichiyama told State of Reform. “Gestational diabetes, heart problems like arrhythmias, can continue way past 60 days after delivery. So we were able to get that into the budget to extend postpartum coverage up to 12 months.”

In Maryland, the coverage extension is expected to impact 11,000 people. The Department of Health submitted its state plan amendment to CMS on June 13th with the intended start date of April 1st. 

“By expanding postpartum care, Maryland has increased access to care during one of the most crucial times for new mothers, parents, and babies,” said MDH Secretary Dennis R. Schrader in the department’s initial announcement in March. “This care is critical to helping set mothers on a path toward a healthier future and ensuring a healthy start for Maryland families.”

ASPE also notes the postpartum extension would be most beneficial for individuals with incomes between 138-250% of the federal poverty level, as their incomes are often too high to qualify for Medicaid as parents. If all states enacted the extension, approximately 720,000 people would gain 12-month postpartum coverage annually, according to ASPE.