Extension of postpartum Medicaid coverage discussed

The Health and Human Services Committee heard testimony Jan. 26 on a bill intended to expand Medicaid coverage for new mothers in Nebraska.

LB929, sponsored by Lincoln Sen. Anna Wishart, would require the state Department of Health and Human Services to submit a plan amendment by Oct. 1, 2022, to extend postpartum coverage for Medicaid recipients from the current 60 days to 12 months.

Under the federal American Rescue Plan Act, states have the option to extend the benefits for five years.

Wishart said she was “shocked” to learn that women currently aren’t given a full year of coverage, considering how important that time is for the physical and mental well-being of children, mothers and families. Current limitations mean that new mothers covered by Medicaid often have only one postpartum visit, she said, while experts recommend that such care be ongoing.

Bob Rauner, representing the Nebraska Academy of Family Physicians, Nebraska Medical Association and Nebraska Association of Physician Assistants, testified in support of the proposal.

Approximately half of all maternal deaths happen in the first year after giving birth, he said, and there is widespread agreement in the medical community that 60 days is not a sufficient timeframe to diagnose and treat the conditions that lead to those deaths — such as hypertension and Type 2 diabetes.

Ann Anderson Berry, a neonatologist and faculty member at the University of Nebraska Medical Center also testified in favor of the bill. Speaking on her own behalf, Anderson Berry said the first year of parenting can be full of anxiety and exhaustion.

Maternal depression rates can be as high as 40 to 60 percent among low-income women and those numbers have increased with the onset of the pandemic, she said, adding that suicide rates among new mothers also have risen in recent years.

“The death of a mother is one of the most tragic events that can befall a family and a community,” Anderson Berry said.

Jo Giles, executive director of the Women’s Fund of Omaha, said studies from other states have found that a significant number of maternal deaths occur outside of the 60-day coverage period. Testifying in support of LB929, Giles said 39 percent of maternal deaths in Nebraska occur later in the postpartum period.

Expanding postpartum coverage would mitigate delays in treatment and support continuity of care, she said, and could reduce overall Medicaid program costs by increasing access to family planning and improving management of chronic conditions before they become expensive to treat.

“The majority of pregnancy related deaths — about 60 percent — are preventable,” Giles said, “and increased access to health care through Medicaid in the year following childbirth will save lives.”

No one testified in opposition to LB929 and the committee took no immediate action on it.