The U.S. Department of Health and Human Services (HHS) marked Black Maternal Health Week by announcing actions to expand access to continuous healthcare coverage and access to preventative care in rural areas to improve maternal health outcomes.
HHS Secretary Xavier Becerra announced that Illinois is the first state to provide continuity of full Medicaid benefit coverage for mothers by offering extended eligibility for a woman during the entire first year after delivery. A new data brief shows that more than half of pregnant women in Medicaid experienced a coverage gap in the first 6 months post-partum and disruptions in Medicaid coverage often lead to periods of un-insurance, delayed care, and less preventive care. The American Rescue Plan provides an easier pathway for states to extend Medicaid postpartum coverage from 60 days to 12 months.
Secretary Becerra also announced a Notice of Funding Opportunity (NOFO) that will make $12 million available over four years for the Rural Maternity and Obstetrics Management Strategies (RMOMS) program that will allow awardees to test models to address unmet needs for their target population. For the first time, applicants are required to focus on populations that have historically suffered from poorer health outcomes, health disparities, and other inequities.
“Expanding access to health insurance coverage, preventative care and investing in rural maternity care is one step forward, “ Becerra said. “Continuous health care coverage reduces health care costs and improves outcomes. By expanding Medicaid eligibility for a full year after delivery, Illinois is setting an important model for other states across the country to follow.”
The Centers for Medicare & Medicaid (CMS) approved Illinois' request to test the effects of providing full Medicaid benefits to women for 12 months, significantly expanding coverage from the current 60-day postpartum period. This approval is effective April 12, 2021 and authorized through Dec. 31, 2025.
The Health Resources and Services Administration’s RMOMS Program will demonstrate the impact of select testing models on maternal and obstetrics care in rural communities nationwide. Three RMOMS award recipients will each receive up to $1 million annually for up to four years to test models to address unmet needs for their target population, which could include populations who have historically suffered from poorer health outcomes, health disparities and other inequities.
Medicaid covers one in 5 women of reproductive age and helps make prenatal and delivery care accessible for nearly half of women giving birth. With a third of maternal deaths occurring between one week to a year after childbirth, and Black women two times more likely to die from a pregnancy related cause than white women, providing this continued Medicaid coverage helps ensure women not only recover from birth, but they also have access to the ongoing care they need during and following giving birth. The continuity of coverage available through this Medicaid amendment can help mothers manage chronic conditions like hypertension and diabetes and provide access to behavioral health and other mental healthcare services.
Illinois projects that annually, approximately 2,500 women with incomes up to 208% of the federal poverty level (FPL) will receive 12 months of continuous Medicaid coverage due to the extension of benefits. Services offered to women during this time will be in accordance with Illinois’ Medicaid state plan. While the extension of benefits is for mothers, it is expected children’s health will benefit as well.
As part of this approval, Illinois has agreed to undertake strong monitoring and evaluation of the demonstration to ensure a thorough assessment of whether the demonstration initiatives are effective in producing the desired outcomes for beneficiaries and the Medicaid program overall. CMS plans to use these monitoring and evaluation results to support future decisions and policy areas.
