What You Need to Know
- The author says CDC show that pregnancy-related deaths can occur as much as a year after delivery.
- Medicaid programs typically limit postpartum coverage to 60 days after a delivery.
- Some states are using Medicaid program waivers to extend postpartum Medicaid eligibility.
Some of the most vulnerable people currently left without coverage under the Affordable Care Act are pregnant women of low-income status. Helping those women should be a top priority.
Despite the ACA covering women’s preventive services at 100%, Medicaid coverage of women’s preventative benefits remains inconsistent across states, since state Medicaid programs are not required to comply with the federal mandate and instead have accepted waivers that limit coverage.
As a result, women living in these states are left without access to important maternal health care, including breastfeeding supplies, support and services — something that is extremely concerning given the high rates of maternal and infant mortality in the United States, particularly among women in low-income communities.
There are steps the Biden administration can take in the short-term to protect these women until a more permanent solution is found.
Here are three of the issues that should be addressed first.
1. Women face many Medicaid eligibility restrictions pre-and-post pregnancy.
Currently, women face substantial Medicaid eligibility restrictions, both pre-and-post pregnancy, in states that have not expanded Medicaid eligibility under the ACA.
These restrictions have had an immense impact on women’s preventative benefits, stripping them of necessary resources to properly care for themselves and their infants postpartum.
While state Medicaid programs offer coverage to pregnant women up to 138% of the federal poverty level (FPL) and most offer coverage above that level, new moms lose coverage just 60 days after giving birth unless they live in an expansion state and remain at or below 138% FPL. Women with incomes above the 138% FPL may qualify for subsidized coverage through the ACA Marketplace; however, even if those women are considered low income, if their income is still too high to qualify for Medicaid as parents and too low for Marketplace subsidies, they are at risk of facing a coverage gap due to scarce affordable coverage options.
In the states that have not expanded eligibility, women can qualify for coverage as parents, but there’s the glaring caveat that the Medicaid income eligibility cut-off is much lower for parents, in all states, than for those who are pregnant.