Extending Postpartum Medicaid to One Year
Breastfeeding has health benefits for both babies and mothers. Breast milk provides a baby with ideal nutrition and supports growth and development. Breastfeeding can also help protect baby and mom against certain illnesses and diseases. U.S. Centers for Disease Control and Prevention, 2023
As the epigraph above makes clear, postpartum care is critically important for the health and wellbeing of both mothers and infants following childbirth. During this vulnerable period of transition and recovery, continued medical support helps detect and address potential complications or risks arising from delivery. The well-being of the mother is a crucial factor in the child's initial year of development. There has also been a rising trend in new mothers actively engaging in breastfeeding postpartum. Breastfeeding offers numerous health advantages, including passive immunity, a healthier digestive system, a reduced incidence of diabetes in breastfed children, and a myriad of other benefits. Continuing Medicaid coverage for mothers throughout the babys first year of life enables these individuals to address their health concerns, potentially mitigating issues that could affect milk production or transmit infections through breast milk. This extended coverage period aligns with the broader goal of promoting maternal and child health during the critical early stages of development.The purpose of this paper is to provide a review of the relevant literature to explain how extending Medicaid coverage for a full 12 months, instead of the current 60 days following childbirth, brings substantial multiple benefits for pregnant individuals meeting the financial need requirement. Following this review, the paper presents a summary of the literature review and important findings concerning the importance of extending postpartum Medicaid to one year in the conclusion.
Review and Discussion
With nearly 4 million births each year, the postpartum period is a time-sensitive opportunity to deliver comprehensive healthcare addressing issues arising from pregnancy and childbirth. Although the American College of Obstetricians and Gynecologists (ACOG) emphasizes a continuum of postpartum care, it recommends a comprehensive postpartum visit within 12 weeks postpartum (Attanasio et al., 2021). Current Medicaid policy, however, allows just 60 days of postpartum coverage following pregnancy, after which new mothers abruptly lose health benefits.
This dangerous coverage gap directly threatens maternal wellness and mortality during a pivotal yet vulnerable recovery stage. Losing access amid worsening national maternal death rates linked to preventable post-delivery complications makes the status quo unconscionable. Congress must act to universally extend pregnancy-related Medicaid to 12 months postpartum in light of states now resuming ineligibility redeterminations. In this regard, the American College of Obstetricians and Gynecologists (ACOG) emphasizes that, Extending Medicaid coverage from 60 days to one year postpartum is especially critical because of the Medicaid unwinding, which began in April 2023 and allowed states restart the process of disenrolling ineligible members from Medicaid (Extend Postpartum Medicaid Coverage, 2023, para. 4). Consequently, increasing numbers of American women are at risk of becoming ineligible for extended postpartum coverage.
With millions slated to be dropped from pandemic coverage waivers, continuing affordability protections would ensure care continuity for lower-income mothers during childbearing years. No new mom should be confronted with coverage denial notices because arbitrary time limits expired before her body or baby fully healed. It is a moral and economic imperative to nurture families by guaranteeing health security during maternity through consistent postpartum safety net access, not just shorter-term maternity alone (Extend Postpartum Medicaid Coverage, 2023).
Attendance rates for postpartum visits in the U.S. vary widely, however, ranging from 50% to nearly 90%. Research indicates that disparities exist, with women of color, uninsured individuals, younger women, those with lower socioeconomic status, and those with delayed prenatal care being less likely to attend (Attanasio et al., 2021). Although every individual case is unique, some of the more common barriers to postpartum care include perceptions of not needing further care, busy schedules with newborn care, and access challenges such as lack of insurance or transportation (Attanasio et al., 2021). Discrimination experiences within the healthcare system contribute to disengagement and avoidance of necessary care, especially among women from marginalized social groups. Notably, women who encountered discrimination during childbirth hospitalization demonstrated lower postpartum visit attendance in a national survey from 20112012 (Attanasio et al., 2021).
The U.S. Centers for Disease Control and Prevention (CDC) reports a notable increase in breastfeeding rates among American mothers, with a rise of over four percentage points in the proportion of breastfeeding mothers from 2000 to 2008. This upward trend is observed across all demographic groups, indicating a positive shift in breastfeeding practices. The report highlights that in 2000, 35% of mothers were breastfeeding at 6 months, a figure that increased to nearly 45% by 2008 (Nordquist, 2013). These positive trends underscore the fact that growing numbers of American women are recognizing the health benefits that accrue to themselves and their babies through breastfeeding, but this uptake is not equally shared among all demographic groups.
While Caucasian women still exhibit higher breastfeeding rates compared to African-American mothers, the gap has reduced from 24 percentage points in 2000...
…that emerged from a study by Boundy et al. (2023) can help improve the understandingof public awareness in the U.S. regarding the maternal health benefits of breastfeeding. The findings of the Bondy et al. (2023) study can enhance public awareness in ways that may persuade political leaders of the need for universally extending Medicaid postpartum care to one full year. For example, data from the 2018 and 2021 surveys were analyzed to investigate American public beliefs regarding specific maternal benefits associated with breastfeeding.Similar to the findings in 2018, the 2021 data revealed a relatively low percentage of respondents who believed that breastfeeding provides protection to the mother against breast cancer (23.9%), high blood pressure (15.5%), or type 2 diabetes (15.4%). The analysis further indicated that male, older, and unmarried respondents were less likely to believe in these protective effects. The study suggests that increasing public awareness of the maternal benefits of breastfeeding could potentially boost demand for programs and policies that support breastfeeding, including Medicaid postpartum coverage (Boundy et al., 2023).
Taken together, it is clear that extending Medicaid coverage for one full year postpartum is a highly cost-effective short- and long-term, evidence-based approach to improving maternal and infant health. Not only can new mothers impart critical nutrients and antibodies that are specific to babies needs, the breastfeeding experience establishes a lifelong bond during this formative period in young peoples lives. Although there are some avenues available for certain states to apply for a Medicaid extension for their constituents, the multiple benefits that accrue to breastfeeding strongly support making this extension universally available. In sum, breastfeeding is superior to all other forms of infant nutrition and the price is right.
Conclusion
The research was consistent in emphasizing the critical importance of ongoing healthcare and support for mothers and babies during the 12 months following childbirth. Although current policy allows just 60 days of Medicaid coverage for low-income women post-pregnancy, deaths and complications peak after this period expires, exacerbated by states redetermining Medicaid income eligibility. Extending coverage for 1 year postpartum ensures care continuity for womens long-term welfare and addresses disparities in access that result in worse outcomes disproportionately impacting minorities. With breastfeeding uptakes also rising, ongoing Medicaid enables mothers to securely nourish babies per medical guidance and address any postpartum health concerns that could impact milk production or transmission. As such, universal extension of Medicaid coverage to 12 months postpartum brings protective, equitable safety net access precisely when family health remains most fragile and lifelong habits…
References
Attanasio, L. B., Ranchoff, B. L., & Geissler, K. H. (2021). Perceived discrimination during the childbirth hospitalization and postpartum visit attendance and content: Evidence from the Listening to Mothers in California survey. PLoS ONE, 16(6), 1–12.
Boundy, E. O., Nelson, J. M., & Li, R. (2023). Public Belief in the Maternal Health Benefits of Breastfeeding - United States, 2018 and 2021. Preventing Chronic Disease, 20, E75.
Breastfeeding Benefits Both Baby and Mom. (2023). U.S. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/nccdphp/dnpao/features/breastfeeding-benefits/index.html#:~:text=Breastfeeding%20can%20help%20protect%20babies,infant%20death%20syndrome%20(SIDS).
Extend Postpartum Medicaid Coverage. (2023). American College of Obstetricians and Gynecologists. Retrieved from https://www.acog.org/advocacy/policy-priorities/extend-postpartum-medicaid-coverage#:~:text=.
Georgetown University McCourt School of Public Policy. (2022). Early Research Shows Benefits of One Year of Postpartum Medicaid. Retrieved from: https://ccf.georgetown. edu/2022/12/15/early-research-shows-benefits-of-one-year-of-postpartum-medicaid-as-states-and-congress-consider/.
Malhi, P., Bharti, B., & Sidhu, M. (2023). Benefits of Breastfeeding, Early Home Stimulation, and Maternal Demographic Factors on Cognitive Functioning of Toddlers. Psychological Studies, 68(4), 563–570.
Medicaid Postpartum Coverage Extension Tracker. (2023). Medicaid. Retrieved from https://www.kff.org/medicaid/issue-brief/medicaid-postpartum-coverage-extension-tracker/.
Nordquist, C. (2013, February 8). Breastfeeding Increasing, says CDC. Medical News Today. Retrieved from: https://www.medicalnewstoday.com/articles/256060#1.
Texas Health and Human Services. Medicaid for Pregnant Women and CHIP Perinatal. Retrieved from: https://www.hhs.texas.gov/services/health/medicaid-chip/medicaid-chip-programs-services/programs-women/medicaid-pregnant-women-chip-perinatal
Tsai, D. (2021, December 7). Improving Maternal Health and Extending Postpartum Coverage in Medicaid and the Children’s Health Insurance Program (CHIP). Centers for Medicaid and Medicaid Services. Retrieved from https://www.medicaid.gov/sites/default/ files/2021-12/sho21007_1.pdf.
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