Arkansas officials believe that the Patient Protection and Affordable Care Act of 2010 (PPACA) could lead to dramatic improvements in health care for pregnant women and new mothers in the state.
Andrew Allison, the medical services division director at the Arkansas Department of Health Services, is preparing to talk about those views Thursday at a hearing organized by the House Energy and Commerce Committee’s health subcommittee.
Rep. Joe Pitts, R-Pa., is organizing the hearing to address concerns by some Republican officials and others who say the U.S. Department of Health and Human Services (HHS) has been slow to provide the regulations and other documents that states, employers and others need to implement the Patient Protection and Affordable Care Act of 2010 (PPACA).
Allison, who supports PPACA, is planning to devote part of his appearance to discussing how he believes the law can help women in his state, according to a written, preliminary version of his testimony posted on the committee website.
The government already pays for a high share of health care for Arkansas women who are pregnant, Allison says in the testimony.
“In Arkansas,” Allison says, “Medicaid currently pays for nearly 66 percent of all births.”
Today, the normal Medicaid program rules forbid a state from providing Medicaid coverage for nonelderly women at any income level unless those women are pregnant or disabled.
To provide any coverage for women who are not pregnant, a state must get a waiver of the usual Medicaid program rules, Allison says.
In practice, Arkansas has been opening Medicaid to pregnant women with incomes of up to 200 percent of the federal poverty level. The state also has been making family planning services, and only family planning services, available to other, non-disabled women of child-bearing age who are not pregnant.
The current rules mean that low-income women who conceive may not have a usual source of care and may have to struggle to get appointments for prenatal care once they suspect that they are pregnant.
About two months after pregnant women who do have Medicaid coverage have their babies, they lose the coverage.
Starting in 2014, PPACA calls for states to expand eligibility for Medicaid to all adults with annual incomes up to 133 percent of the federal poverty level, or about $15,000 per year for a single woman and about $30,600 per year for a mother in a family of four.
HHS has come out with regulations that could affect when women will have to move from one type of Medicaid plan to another and when they can stay in the Medicaid plan they’re already in.
Because of a combination of the Medicaid expansion provisions, private health coverage access provisions, and the Medicaid coverage continuity regulations, “it is now clear that pregnant women will no longer need to wait until they are pregnant to have access to affordable care,” Allison says.
Women who are in Medicaid and get pregnant will simply stay in their current Medicaid plans, without having to bounce back and forth between the “old Medicaid” eligibility group and the new “expansion Medicaid group,” Allison says.
PPACA Medicaid expansion funding should help Arkansas cut the cost of covering pregnant women by about $21 million per year, Allison says.
Reducing the likelihood that women will have to move from one plan to another “will promote continuity of coverage, better preventive and prenatal care,” Allison says.
Moreover, because pregnant Arkansas women with incomes between 133 percent of the federal poverty level and 200 percent of the federal poverty level will no longer have access to the state’s Medicaid program, those women may be more likely to have private health coverage, Allison says.