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house Bill H.R. 4996

Should Medicaid Cover a Year of Postpartum Care for Moms?

Argument in favor

Maternal mortality has worsened in the U.S. over the past decades, and poor postpartum care, particularly for low-income moms, is one culprit. Extending postpartum care under Medicaid to a year, rather than the current 60 days, would help address preventable maternal deaths and improve maternal health overall.

jimK's Opinion
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09/29/2020
More and more cases are being made for universal healthcare and healthcare services that benefit the all of us. Hey, maybe with all of our great medical expertise, the latest proven medical devices, the world leading medical scientists; maybe we can get our population to began to meet the same health metrics met by many other countries world wide, instead of being way down the lists on things like life expectancy, infant mortality, deaths preventable by early medical treatment and others. The best solution for postpartum care would be universal healthcare.
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Leslie's Opinion
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09/29/2020
Yes! Being Pro-life means supporting mothers and children. To not is only Pro-birth! @Robert: Medicaid eligibility requirements eliminate many. It varies by state & the number of children ranging from an income less than $13K to $57K (with 8 children) deemed to be below the poverty line, be a US citizen, resident of the state filing in, within an age range & pregnancy status. Medicaid currently covers about 13M woman age 15-44. https://www.policygenius.com/blog/a-state-by-state-guide-to-medicaid/ https://www.medicaid.gov/medicaid/eligibility/index.html https://www.cbpp.org/research/health/medicaid-works-for-women-but-proposed-cuts-would-have-harsh-disproportionate-impact
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burrkitty's Opinion
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09/29/2020
I’d rather spend my taxes on new moms than new wars. Let’s stop buying the broken F-35 and pay for this instead. Up to three kids. @bullmom So what? Your complaint commoditizes human life to make someone’s “value” based only on how much money make. Real moral. What a fine example of “Christianity”.
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Argument opposed

This legislation is unnecessary, as the Centers for Medicare & Medicaid Services (CMS) and states already have the ability to expand access to postpartum care under Medicaid without federal legislative action if they believe it’s beneficial to do so.

FieryFierce's Opinion
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09/29/2020
I do not agree with a year. I do agree with extending for 90 days with education in how to care for your child at home along with vaccination education, etc.
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Diana's Opinion
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09/29/2020
iF YOU PAID FOR BIRTH CONTROL FOR SOME OF THESE WOMEN THEN THEY WOULDN'T BE HAVING BABIES!!!! OH THAT'S RIGHT YOUR TRYING TO TAKE AWAY PLANNED PARENT HOOD!!!
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Guy's Opinion
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09/29/2020
Care should be capped at a certain number of visits or a set dollar amount.
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What is House Bill H.R. 4996?

This bill, known as the Helping Medicaid Offer Maternity Services (MOMS) Act of 2019, would allow states to provide one year of postpartum coverage under Medicaid and the Children’s Health Insurance Program (CHIP). Under current law, states can provide 60 day of postpartum coverage. To incentivize extension, this bill would provide a one-year, five percentage point Federal Medical Assistance Percentage (FMAP) enhancement, thereby increasing federal funding for Medicaid in states that implement the postpartum coverage extension.

Additionally, this bill would require the Medicaid and CHIP Payment and Access Commission to report on specified information relating to coverage of doula services under state Medicaid programs. This would include coverage barriers and recommendations for improvement.

Impact

New moms; Medicaid; Medicaid coverage for postpartum moms.

Cost of House Bill H.R. 4996

A CBO cost estimate is unavailable.

More Information

In-Depth: Sponsoring Rep. Robin Kelly (D-IL) introduced this bill to address the United States’ maternal mortality crisis:

“Incentivizing postpartum Medicaid expansion is a critical first step in preventing maternal deaths by ensuring new moms can see their doctor. I’m proud that my colleagues, on both sides of the aisle, came together to put an end to the sad reality of American moms dying while growing their families. We can’t allow the perfect to be the enemy of the good. This is a good, bipartisan first step, but it must be the first of many.”

Every Mother Counts is among a number of maternal health organizations supporting this legislation. Its members write:

“Every Mother Counts writes to express our support for the bipartisan Helping Medicaid Offer Maternity Services Act (H.R. 4996). Every Mother Counts is a non-profit organization seeking to make pregnancy and childbirth safe for every mother, everywhere, by working to achieve quality, respectful, and equitable maternity care for all. We appreciate your leadership in ensuring that the U.S. maternal healthcare crisis receives the attention required to improve the health and healthcare experiences of women and infants across the country, and to eliminate the extreme health disparities affecting communities of color and Indigenous communities.”

While it supports federal legislation to expand postpartum coverage under Medicaid, the Center on Budget and Policy Priorities (CBPP) notes that the Centers for Medicare & Medicaid Services (CMS) and states already have the ability to expand access to postpartum care under Medicaid without federal legislative action.

This legislation passed the House Committee on Energy and Commerce with the support of 36 bipartisan cosponsors, including 26 Democrats and 10 Republicans. It has been endorsed by many leading health and family advocates, including the American College of Obstetricians and Gynecologists (ACOG), Blue Cross Blue Shield Association, and Black Women’s Health Imperative.


Of NoteMaternal mortality outcomes in the U.S. have deteriorated in recent years, to the point that it was more dangerous to have a baby in 2018 than it was in 1985. Maternal mortality risk is higher among Black mothers, with Black women dying due to maternity-related causes at 3-4 times the rate of white women.

According to the Centers for Disease Control and Prevention (CDC), 700-900 American moms die due to pregnancy or birth-related complications; statistics compiled by the American College of Obstetricians and Gynecologists (ACOG) suggest that more than half of these deaths are preventable by improved access to healthcare.

Currently, the majority of pregnancy-related deaths in the U.S. occur after the day of delivery, and nearly a quarter of deaths happen more than six weeks postpartum. However, Medicaid currently only covers women for two months after their babies’ births. 

An increasing volume of literature indicates benefits to having Medicaid coverage for one year postpartum. With over 40% of births in the U.S. covered by Medicaid, expanding postpartum coverage under Medicaid to a year could affect many mothers.

The Commonwealth Fund observes that Medicaid is well-positioned to provide postpartum care:

“Medicaid is well positioned to provide this kind of coverage and care. It has broad reach — it covered around 42 percent of births in the United States in 2018. And it is making a difference: in Medicaid expansion states, maternal mortality dropped by 1.6 deaths per 100,000 women. Extending Medicaid coverage for pregnant women in every state for a full year after birth is a first step to eliminating disparities and improving outcomes. We are already seeing the effects of increasing coverage on health outcomes, with decreasing maternal mortality rates in Medicaid expansion states. The impact could be even greater if all Medicaid-covered pregnant women were able to keep their coverage for a longer period, a move that would support the transformation of maternity care.”

To date, 36 states and the District of Columbia have adopted expanded eligibility for Medicaid under the Affordable Care Act (ACA), allowing low-income women to continue their pregnancy-related Medicaid coverage after the 60-day postpartum period. This includes multiple states in which legislative action to extend Medicaid coverage has been taken. However, in the 14 states that haven’t adopted the ACA’s Medicaid expansion, postpartum women need to requalify for Medicaid as parents to stay on the program.

Writing for The Incidental Economist, Urban Institute researchers Stacy McMorrow, Genevieve M. Kenney, Emily M. Johnston, and Jennifer Haley found that expanding Medicaid coverage for postpartum women would benefit at least 200,000 low-income uninsured citizen new mothers:

“Extending postpartum Medicaid coverage has the potential to help at least 200,000 low-income uninsured citizen new mothers gain coverage. Others with higher incomes and some noncitizen mothers could also benefit, especially in states that currently provide more generous pregnancy-related coverage through Medicaid or the Children’s Health Insurance Program. A postpartum extension would allow new mothers to maintain continuity of care in the year following delivery, access critical health services as they recover from pregnancy and delivery, and potentially transition to other sources of coverage on a more flexible timeline. A postpartum Medicaid extension would only benefit women in the first year after pregnancy, however, leaving other low-income mothers and fathers at risk of uninsurance, particularly in nonexpansion states. Evidence from the ACA Medicaid expansion suggests that a more comprehensive expansion has the potential to increase coverage, access to care, and financial well-being among both new mothers and other parents.”


Media:

Summary by Lorelei Yang

(Photo Credit: Unsplash / Sharon McCutcheon)

AKA

Helping MOMS Act of 2020

Official Title

Helping MOMS Act of 2020, as amended

bill Progress


  • Not enacted
    The President has not signed this bill
  • The senate has not voted
  • The house has not voted
    IntroducedNovember 8th, 2019
    More and more cases are being made for universal healthcare and healthcare services that benefit the all of us. Hey, maybe with all of our great medical expertise, the latest proven medical devices, the world leading medical scientists; maybe we can get our population to began to meet the same health metrics met by many other countries world wide, instead of being way down the lists on things like life expectancy, infant mortality, deaths preventable by early medical treatment and others. The best solution for postpartum care would be universal healthcare.
    Like (27)
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    I do not agree with a year. I do agree with extending for 90 days with education in how to care for your child at home along with vaccination education, etc.
    Like (6)
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    Yes! Being Pro-life means supporting mothers and children. To not is only Pro-birth! @Robert: Medicaid eligibility requirements eliminate many. It varies by state & the number of children ranging from an income less than $13K to $57K (with 8 children) deemed to be below the poverty line, be a US citizen, resident of the state filing in, within an age range & pregnancy status. Medicaid currently covers about 13M woman age 15-44. https://www.policygenius.com/blog/a-state-by-state-guide-to-medicaid/ https://www.medicaid.gov/medicaid/eligibility/index.html https://www.cbpp.org/research/health/medicaid-works-for-women-but-proposed-cuts-would-have-harsh-disproportionate-impact
    Like (23)
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    I’d rather spend my taxes on new moms than new wars. Let’s stop buying the broken F-35 and pay for this instead. Up to three kids. @bullmom So what? Your complaint commoditizes human life to make someone’s “value” based only on how much money make. Real moral. What a fine example of “Christianity”.
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    Better idea: Medicare for All & get rid of Medicaid altogether! Then yes cover postpartum care for moms...all moms! Do it cheaper & with better outcomes.
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    Why the hell wouldn't they and....it seems that the "Pro life" party would certainly want this.
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    Yes, postpartum depression is a concern for mothers, as is the disproportionality high mortality rate of black babies and their mothers. Medicaid should fully cover healthcare for mothers in the first year of a child's life to be sure both the baby and the mother are thriving and have a good start.
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    Why should lower income women and their children have less access to care than those who are more fortunate and more affluent? This one is just a no brainer. This is good for the whole of society, not just the recipients.
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    If we are going to be pro-life, it’s time we take care of the moms, so they in turn can care for the babies.
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    Should be part of planned Parenthood, they are best to handle this and other thing, Also healthcare for all. If you combine all the support organizations, this could stream line, make them more efficient and cost less!
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    The argument about what states COULD do lacks merit. Clearly some states will never offer services that are not required. This is a Federal program, and while administered by the states, requires Federal standards as a minimum. A requirement of one year maternal coverage is not unreasonable, and ensures that the first critical year of a qualified child's life and that period when the mother is at greatest risk will include medical support.
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    We are number one in several things in this country however preforming so badly in maternal health care is a National disgrace. Being #1 in postpartum deaths in developed nations shows a lack of priority for women’s and infants healthcare in this country. You want to be pro-life? This is where you should start.
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    Of course!!!
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    Civilized societies in this world already do this or something similar. That says a lot about us in the United States. What do you value? Money or people? War or children? It’s not a both-and solution.
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    Until that glorious day when we join the rest of the world in providing healthcare for all then this is needed. Healthy infants grow into better citizens who are more productive. Healthy moms nurture healthy infants.
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    Medicare should cover every American and do away with the real death panels, the insurance company’s.
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    Awkward responding to this as a male member of society. I think all children deserve a fair shot at life. They didn’t ask to be born. Hopefully parents are prepared to do the job but assistance should be readily available if needed. But I might limit it to two? Messy topic.
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    iF YOU PAID FOR BIRTH CONTROL FOR SOME OF THESE WOMEN THEN THEY WOULDN'T BE HAVING BABIES!!!! OH THAT'S RIGHT YOUR TRYING TO TAKE AWAY PLANNED PARENT HOOD!!!
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    Most certainly. A newborn in the USA should get a healthy head start, don’t you agree?
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    As you can see I'm not a woman. I can't have children naturally. But, one thing in common is, DEPRESSION! I've been trying to overcome this depression for 20+ years(42 yrs of age). I am a human guinea pig. And, nothing works/worked/ working. PPD, goes away if treated right away and correctly. But, I've been suffering for much longer. I can't imagine having to take care of a newborn baby, in that state of mind(that nobody knows, until they experience it themselves!) If one thing I learned in 42 years on this spinning ball of water, shaped like a sphere; YOU DON'T KNOW WHAT THEY'RE TALKING ABOUT, UNLESS YOU'VE BEEN THROUGH IT. BOTTOM LINE. So, stop telling people you understand, when you have never been through a situation that is even similar to. Just have empathy. BBLU
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