Supporting Maternal Health Through Medicaid & the Children’s Health Insurance Program
As noted in a report published by the Health & Human Services (HHS) Office of Assistant Secretary for Planning and Evaluation, one in three pregnancy-related deaths occur between one week and one year after childbirth. The postpartum period is critical for recovering from childbirth, addressing complications of delivery, ensuring mental health, managing infant care, and transitioning from obstetric to primary care.
The Biden-Harris Administration has made expanding access to high-quality, affordable health care a top priority. Because of many administration efforts, more people than ever before have health insurance coverage. At CMS, these efforts include:
- Guaranteed access to Medicaid for a year after pregnancy. Thanks to the American Rescue Plan Act of 2021 (ARP), states can provide continuous Medicaid and Children’s Health Insurance Program (CHIP) coverage for a full year after pregnancy, up from 60 days prior to the ARP. When states use this option, Medicaid and CHIP enrollees have 12 months of postpartum coverage regardless of the changes in circumstances the person may experience, such as an increase in income. This extended coverage option offers states an opportunity to provide care that can reduce pregnancy-related deaths and severe maternal morbidity, and improve continuity of care for chronic conditions.
- Establishing a “Birthing-Friendly” Hospital Designation. In the 2023 inpatient prospective payment system (IPPS) proposed rule, CMS announced plans to establish a “Birthing-Friendly” hospital designation – a publicly-reported, public-facing hospital designation on the quality and safety of maternity care. CMS is establishing this hospital designation in fall 2023. As finalized, CMS will award this designation to hospitals that report “Yes” to both questions in the Maternal Morbidity Structural Measure, reporting that the hospital participated in a national or statewide quality collaborative and implemented all recommended interventions. CMS also issued a request for information in which the agency sought and received comments on how it could address the U.S. maternal health crisis through policies and programs, including, but not limited to, the Conditions of Participation and through measures in our quality reporting programs. A summary of these comments was provided in the IPPS final rule and will be used to inform potential future policy development.
The Biden-Harris Administration has championed policies to improve maternal health and equity since the President and Vice President first took office.
- In April 2021, President Biden issued the first-ever presidential proclamation marking Black Maternal Health Week.
- In December 2021, Vice President Harris hosted the first-ever White House Maternal Health Day of Action, during which she announced important commitments to address the maternal health crisis.
- The Vice President further issued a call to action to the private and public sectors to improve maternal health outcomes, urging states to extend Medicaid coverage for postpartum women from two to 12 months, as well as announcing guidance for how states could extend their coverage.
- The Vice President has since convened a historic meeting with cabinet secretaries and agency leaders – including CMS Administrator Brooks-LaSure – to discuss the administration’s whole-of-government approach to addressing maternal mortality and morbidity.
- In June 2022, the White House released the Biden-Harris Administration’s Blueprint for Addressing the Maternal Health Crisis, a whole-of-government approach to combatting maternal mortality and morbidity. For far too many people, complications related to pregnancy, childbirth, and the postpartum period can lead to devastating health outcomes and result in hundreds of deaths each year. This maternal health crisis is particularly devastating for Black and American Indian and Alaska Native people, and those in rural communities, who all experience maternal mortality and morbidity at significantly higher rates than their white and urban counterparts.
- In July 2022, CMS released its Maternity Care Action Plan to support the implementation of the Biden-Harris Administration’s Blueprint, which includes postpartum coverage extensions through Medicaid and CHIP. The action plan takes a holistic and coordinated approach across CMS to improve health outcomes and reduce disparities for people during pregnancy, childbirth, and the postpartum period. CMS’ implementation of the action plan will support the Biden-Harris Administration’s broad vision and call to action to improve maternal health.