The column below reflects the views of the author, and these opinions are neither endorsed nor supported by WisOpinion.com.
We are in an unfortunate moment in our country when maternal death rates are rising. Many who survive pregnancy and the postpartum period may experience severe health conditions that require ongoing treatment, but current Medicaid coverage ends at 60 days postpartum. Senate Bill 562 and Assembly Bill 592, which would extend Medicaid benefits in Wisconsin for the full 12 months postpartum, will help address this maternal health crisis.
It is no wonder that the Wisconsin Maternal Mortality Review Committee (MMRC), after determining that the rates for pregnancy-related mortality among non-Hispanic black mothers is 5 times the rate for non-Hispanic white mothers, that more than 2 out of 3 pregnancy-related deaths occur postpartum, and that 65% of pregnancy-associated deaths occurred more than 42 days postpartum, has recommended extending postpartum Medicaid coverage to 12 months.
Obstetricians like me want our patients to thrive, but we need help in stopping these preventable deaths. We have the medical knowledge to care for our patients and to offer them life-saving treatment, but we need to allow access to care throughout the full postpartum period of 12 months. By extending Medicaid coverage to 12 months postpartum, we have an opportunity to make our systems work better for our patients and the mothers of Wisconsin. That’s why Senate Bill 562 and Assembly Bill 592 matter.
One of my own patients who I’ll call Angie learned just before delivery that she had developed a condition called peripartum cardiomyopathy, which impacts her heart’s ability to effectively pump blood through her body. At the same time that Angie was welcoming her beautiful baby girl into the world, she was learning about the long-term health implications, necessary tests and ongoing treatment she would need: follow up with a cardiologist, Echocardiogram, medications. This could be controlled, but only with long-term access to care.
With Medicaid coverage expiring after only 60 days postpartum, patients like Angie are up against a clock as they face their own new health conditions and the impending loss of access to life-improving and sometimes life-saving treatment.
Twelve months of postpartum Medicaid coverage will also help ensure that Wisconsin’s new mothers have the support they need as they begin motherhood or grow their existing families. Time and again, obstetrician-gynecologists like me see patients up to six months after birth who are not yet experiencing the harmful mood concerns associated with postpartum depression. But their situations may change with evolving support systems – when they or a partner returned to a job or when they lost the support of a visiting family member – and the symptoms of depression can emerge well after the time runs out on their postpartum Medicaid coverage. To help them regain the ability to take joy in their growing families, to get ahead of long-term mental health challenges, and even to protect their lives, they need care when they need it and without concerns about insurance disruptions.
From chronic conditions that predate pregnancy to complications that emerge during pregnancy to the ability to prevent future pregnancies through postpartum contraception, stopping postpartum Medicaid coverage after only 60 days simply doesn’t make sense.
Many patients after birth have lives that are complicated: finding childcare, returning to work without additional remaining sick time, family or relationship stressors, medical illnesses. The burden of worrying about insurance disruptions can be additionally stressful and harmful.
Maternal health experts across the country, including in the state of Wisconsin, agree that extending postpartum Medicaid coverage would benefit our patients and help us turn the tide of the maternal mortality crisis in this country. Both red states and blue states have adopted this policy as a strategy for ending preventable maternal deaths, and recent federal legislation has made it even easier for Senate Bill 562 to pass by allowing federal matching dollars for the coverage extension. Now is the time to act to protect our patients because moms can’t wait.
– Domeyer-Klenske, MD, is vice chair of the Wisconsin Section of the American College of Obstetricians and Gynecologists
