The National Blood Clot Alliance, alongside 109 other national nonprofits recently asked congress to establish permanent, nationwide 12-month postpartum Medicaid coverage for women in the United States. Read the letter that was sent to Congress below, or download it here.
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.i Racial disparities in maternal outcomes persist: Black and Indigenous birthing people die at 2-3 times the rate of their white counterparts.ii 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.iii 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.iv,v 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 ahaddad@amchp.org for more information.
Sincerely,
1,000 Days, an Initiative of FHI Solutions
2 Degrees Foundation
2020 Mom
Academic Pediatric Association
Academy of Nutrition and Dietetics
AFE Foundation
African American Mayors Association
AIDS Alliance for Women, Infants, Children, Youth & Families
Alliance for Black NICU Families
Alliance of Community Health Plans
American Academy of Family Physicians
American Academy of Pediatrics
American College of Clinical Pharmacy
American College of Nurse-Midwives
American College of Obstetricians and Gynecologists
American College of Physicians
American Foundation for Suicide Prevention
American Heart Association
American Nurses Association
American Osteopathic Association
American Pediatric Society
American Psychiatric Association
American Psychological Association
APS Foundation of America, Inc
Association for Community Affiliated Plans
Association for Prevention Teaching and Research
Association of American Medical Colleges
Association of Maternal & Child Health Programs
Association of Medical School Pediatric Department Chairs
Association of State Public Health Nutritionists
Association of University Centers on Disabilities
Birthing Beautiful Communities
Black Mamas Matter Alliance
Blue Cross Blue Shield Association
Catholic Health Association of the United States
Center for Law and Social Policy (CLASP)
Centering Healthcare Institute
centro Pediatrico de lactancia y crianza
Children’s Environmental Health Network
CityMatCH
Community Catalyst
Diversity Uplifts, Inc.
Division for Early Childhood of the Council for Exceptional Children (DEC)
Every Mother Counts
First Focus Campaign for Children
Futures Without Violence
GLO Preemies
Guttmacher Institute
Hand to Hold
HealthConnect One
Healthy Teen Network
HealthyWomen
Hemophilia Federation of America
3 of 4
Hyperemesis Education and Research Foundation
IDEA Infant and Toddler Coordinators Association (ITCA)
In Our Own Voice: National Black Women’s Reproductive Justice Agenda
Institute for Perinatal Quality Improvement
March for Moms
March of Dimes
Maternal Mental Health Leadership Alliance
Medela LLC
Medicaid Health Plans of America
Mom Congress
MomsRising
NARAL Pro-Choice America
National Association for Children’s Behavioral Health
National Association of Councils on Developmental Disabilities
National Association of Counties
National Association of Nurse Practitioners in Women’s Health
National Association of Pediatric Nurse Practitioners
National Birth Equity Collaborative
National Black Women’s HIV/AIDS Network
National Blood Clot Alliance
National Blood Clot Awareness
National Family Planning & Reproductive Health Association
National Health Law Program
National Healthy Start Association
National Lactation Consultant Alliance
National League for Nursing
National Nurse-Led Care Consortium
National Partnership for Women & Families
National Rural Health Association
National WIC Association
National Women’s Health Network
Network of Behavioral Health Providers
Nurse-Family Partnership
Organization of Teratology Information Specialists
Parents as Teachers
PCOS Challenge: The National Polycystic Ovary Syndrome Association
Pediatric Policy Council
Physicians for Reproductive Health
Planned Parenthood Federation of America
Postpartum Pelvic Health Advocates
Postpartum Support International
Power to Decide
RESULTS
School-Based Health Alliance
Society for Maternal-Fetal Medicine
Society for Pediatric Research
Society for Reproductive Investigation
Society for Women’s Health Research
Start Early
The Joint Commission
The National Alliance to Advance Adolescent Health
The PPROM Foundation
The Shane Foundation
U.S. Breastfeeding Committee
United Cerebral Palsy
What to Expect Project
CC:
The Honorable Patrick Leahy
The Honorable Richard Shelby
The Honorable Rosa DeLauro
The Honorable Kay Granger
The Honorable Frank Pallone
The Honorable Cathy McMorris Rodgers
The Honorable Ron Wyden
The Honorable Mike Crapo
i Centers for Disease Control and Prevention (CDC). Maternal Mortality Rates in the United States, 2020. Accessed September 14, 2022. Available at: https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2020/maternal-mortality-rates-2020.htm.
ii Centers for Disease Control and Prevention (CDC). Pregnancy Mortality Surveillance System. Accessed September 14, 2020. https://www.cdc.gov/reproductivehealth/maternal-mortality/pregnancy-mortality-surveillance-system.htm#race-ethnicity.
iii Centers for Disease Control and Prevention (CDC). Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees in 36 states, 2017-2019. Accessed September 20, 2022. Available at: https://www.cdc.gov/reproductivehealth/maternal-mortality/erase-mm/data- mmrc.html#table3.
iv Medicaid and CHIP Payment Access Commission (MACPAC). Medicaid’s Role in Financing Maternity Care. Accessed September 14, 2022. https://www.macpac.gov/wp-content/uploads/2020/01/Medicaid%E2%80%99s-Role-in-Financing-Maternity-Care.pdf.
v Kaiser Family Foundation (KFF). Medicaid Coverage for Women. Accessed September 22, 2022. https://www.kff.org/womens-health- policy/issue-brief/medicaid-coverage-for-women/.
vi Centers for Disease Control and Prevention (CDC). Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees in 36 states, 2017-2019. Accessed September 20, 2022. Available at: https://www.cdc.gov/reproductivehealth/maternal-mortality/erase-mm/data- mmrc.html#table3.
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