Postpartum Medicaid, breast cancer screenings among Women’s Legislative Caucus bills

By

Nicole Pasia

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A bipartisan, bicameral bill package will prioritize women’s health during Hawaii’s 2022 Legislative Session. The 2021-2022 Women’s Legislative Caucus (WLC), consisting of 16 women representatives and 10 women senators, aims to pass bills that will extend postpartum Medicaid coverage and access to mammograms. WLC announced their eight-bill 2022 legislative package at a panel discussion with the YMCA of Oahu last week.

 

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Hawaii’s WLC was established over 20 years ago. Aside from access to health care, previous legislation focused on reducing violence against and increasing education opportunities for women. 

This year WLC dedicated its package to the 50th anniversary of Title IX, or the Equal Opportunity in Education Act of 1972, which was co-authored by the late Congresswoman Patsy T. Mink. She was also the first Japanese American woman admitted to practice law in Hawaii. 

Among the bills in this year’s package, S.B. 2634 would amend the state Medicaid plan to extend coverage for postpartum beneficiaries from 60 days to 12 months. Hawaii would join other states that have implemented this change, including Virginia and Illinois

“Women who are ineligible for postpartum health coverage struggle to get necessary care during the twelve months following childbirth,” the bill states. “… Drug overdoses, suicides, and pregnancy-related chronic illnesses including diabetes, heart disease, and high blood pressure contribute to a rise in deaths among women during pregnancy, childbirth, and the first twelve months after childbirth.”

Data from the 2019 Hawaii Maternal Mortality Review Committee found that half of maternal deaths occur between 43 days to one year after birth, many of which were preventable with adequate access to care. Although beneficiaries can reapply for Medicaid coverage as parents, the income eligibility floor is lower than those of postpartum individuals, rendering some ineligible. 

The bill has been referred to the Senate Committees on Health, Human Services, and Ways and Means. Although an amount has not yet been determined, S.B. 2634 would appropriate general funds for the coverage extension, and would draw down federal matching funds. If passed, the bill will take effect July 1, 2022.

S.B. 827 and S.B. 2635 aim to increase coverage for mammography, or breast cancer screenings. Breast cancer disproportionately affects women of color, according to Oahu-based radiologist Scott Grosskreutz, M.D. His research indicates 30% of cancers in Black, Hispanic, Asian, and Pacific Islander women in the U.S. occur before age 50, and that breast cancer mortality rates are highest among Native Hawaiians. 

Grosskreutz said early detection through mammograms is key to avoiding poor health outcomes. S.B. 827 would require health plans to cover annual mammograms for women aged 40 or older, as well as a “formal risk factor screening assessment” for women aged 30 or older. The bill was carried over from the 2021 Session and has been referred to the House Committee on Health, Human Services, and Homelessness.

S.B. 2635 would require health plans to cover mammograms “at least as favorably” as other radiological exams. This means the dollar limits, deductibles, and co-payments for a mammogram would follow the same terms under a health plan as ultrasounds, MRI, or CT scans. The bill passed its first reading last week and has been referred to the Senate Committees on Health and Consumer Protection and Commerce.

Senate Vice President and WLC member Michelle Kidani (D – Mililani Town) reflected on the importance of this year’s bill package. 

“I am proud to support this package to improve the health and safety of women and children in Hawaiʻi,” she said in the package announcement. “Throughout this pandemic, we have seen the importance of access to quality health care, including for new mothers and their babies.”

See the full WLC 2022 Bill Package here.