The American Rescue Plan Act’s State Option to Extend Postpartum Coverage

Prepared for the Robert Wood Johnson Foundation’s State Health and Value Strategies program

The American Rescue Plan Act of 2021 (ARP) establishes a new state option to extend Medicaid and Children’s Health Insurance Program (CHIP) coverage for pregnant women for one year following the baby’s birth. Under current law, Medicaid and CHIP pregnant women’s coverage extends only through 60 days postpartum. A woman loses her Medicaid or CHIP coverage at the end of her 60-day postpartum period if she is not eligible for coverage under another Medicaid eligibility category (e.g., the new adult or parent group). ARP’s new state option to extend continuous coverage for one year postpartum enables states to take a major step toward improving health outcomes for postpartum women and their babies by mitigating coverage loss, providing comprehensive coverage in the postpartum period to address maternal mortality and morbidity, and advancing health equity.

There is considerable evidence supporting the policy decision to extend postpartum coverage; about 12 percent of pregnancy-related deaths occur between six weeks and one year postpartum. Despite approximately 60 percent of all maternal deaths in the United States being preventable, an estimated 700 women die each year as a result of pregnancy or delivery complications, and women of color are disproportionately affected. Maternal morbidity in the United States has been on the rise since 1993, with women of color experiencing significantly higher rates of severe maternal morbidity than their white counterparts. Pregnancy-related complications affecting the mother tend to translate to adverse health outcomes experienced by the baby.

In an issue brief for the Robert Wood Johnson Foundation’s State Health and Value Strategies program, Manatt Health examines key policy and operational considerations for states around ARP’s new state option to extend postpartum coverage, including eligible populations, covered benefits, financing and State Plan Amendments. The brief also addresses Section 1115 postpartum coverage extension considerations and looks ahead to what’s next.

Click here to download the full issue brief.

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