Dear Speaker Pelosi, Majority Leader Schumer, Leader McCarthy, and Leader McConnell:
We, the undersigned 109 national organizations committed to improving the health and wellbeing of our nation’s families, commend your ongoing leadership to advance legislation to improve maternal health. As we approach the end of the 117th Congress, we urge you to include language establishing permanent, nationwide 12-month postpartum Medicaid coverage in a year-end legislative package. While the state option to extend coverage in the American Rescue Plan Act (P.L.117-2) was an important down payment, further Congressional action is needed to reduce disparities in coverage across states, eliminate racial inequities in maternal health outcomes, and end preventable maternal deaths.
The United States faces a severe – and worsening – maternal health crisis. Over 800 women died due to pregnancy or childbirth in 2020, a record high exacerbated by the COVID-19 pandemic. Racial disparities in maternal outcomes persist: Black and Indigenous birthing people die at 2-3 times the rate of their white counterparts. These rates reveal the long-standing inequities within our health care system and the racial and ethnic disparities in health outcomes. Further, research from the U.S. Centers for Disease Control and Prevention (CDC) based on state Maternal Mortality Review Committee data found that at least 80% of pregnancy-related deaths are preventable. We can and must do better to prevent maternal mortality.
Extending Medicaid coverage from the current requirement of 60-days postpartum to 12-months nationwide is critical to lowering the nation’s alarming maternal mortality rate. The Medicaid program covers at least 40% of all births in the United States, a disproportionate number of which are to Black, Hispanic, and Indigenous women. In the first year postpartum, new parents can face a multitude of health challenges, including pregnancy-related complications, exacerbated chronic conditions, mental health conditions, and substance use disorders. According to the CDC, over half of pregnancy-related deaths between 2017 and 2019 occurred between one week and one- year postpartum with nearly a third occurring after 43 days postpartum.vi Twelve months of continuous Medicaid eligibility for postpartum individuals would remove key access barriers that often prevent them from getting the care they need after birth.
We must build upon the 12-month postpartum Medicaid coverage option provided to states in the American Rescue Plan Act to ensure all enrollees, regardless of zip code, can access continuous care. Without Congressional action, the state option will expire in 2027. This looming deadline causes uncertainty and administrative burden to states that have taken action, and disincentivizes the remaining states to take advantage of the option as time goes on.
Thank you for your commitment to securing the health and wellbeing of our nation’s families. We look forward to working with you to ensure that postpartum individuals in every state and territory have access to a minimum of 12- months of Medicaid coverage. Please contact Amy Haddad, Chief Government Affairs Officer for the Association of Maternal & Child Health Programs (AMCHP), at firstname.lastname@example.org for more information.