Article Summary

Despite being a high-income country that ranks among the top across the world in health technologies, the USA lags behind other high income countries in maternal health outcomes. The country has adopted different measures to prevent deaths during labor and delivery, but women are still more likely to die from a pregnancy related issue in the USA than other high income countries.  Article Summary Discussion Paper  Extending Medicaid eligibility for women to beyond 60 days of the post-partum period has been suggested as an appropriate strategy for improving maternal health outcomes. The article that I chose discusses the legislative and regulatory pathways that can be adopted to postpartum Medicaid eligibility for women. Women lose Medicaid coverage 60 days after the end of the pregnancy.

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This implies that pregnant women who are a mandatory population under Medicaid may be unable to access healthcare once the coverage period end. There are state policies that can be explored to ensure that women continue to receive care beyond the 60 days’ post-partum coverage period. Firstly, implementing waivers that extend the Medicaid coverage at the state level. Waivers can be approved every five years. Still, this approach presents some setbacks that include state administrative burden of waiver application, need for approval at regular intervals, monitoring and evaluation requirements, need for CMS approval for state waiver application, and CMS requirement for budget neutrality. Secondly, implementing a state-only approach that has the state fully financing the Medicaid extension beyond 60 days postpartum. This is initiated through executive or legislative action. In addition to the two state policies, federal policies can also be adopted. A federal mandate that modifies the Medicaid statute so that it extends the coverage period. Still, this approach could invite significant opposition over legal and cost concerns (Daw et al., 2021). Overall, the article reveals that there is a need to extend Medicaid coverage for women beyond 60 days’ postpartum period in order to improve maternal health outcomes.

Reference

Daw, J. R., Eckert, E., Allen, H. L., & Underhill, K. (2021). Extending Postpartum Medicaid: State and Federal Policy Options during and after COVID-19. Journal of Health Politics, Policy and Law, 46(3), 505-526. https://doi.org/10.1215/03616878-8893585  .  Article Summary Discussion Paper