Illinois first state to extend full Medicaid benefits to mothers 12 months postpartum

Illinois first state to extend full Medicaid benefits to mothers 12 months postpartum
Women with incomes up to 208 percent of the federal poverty level will have continuous Medicaid eligibility through 12 months postpartum. (Source: Pexels)

SPRINGFIELD, Ill. (KFVS) - Illinois became the first state to extend full Medicaid benefits from 60 days to 12 months postpartum.

This followed the federal Centers for Medicare and Medicaid Services approval of Illinois’ 1115 waiver allowing for the extension.

The extension is aimed at reducing the rate of maternal morbidity and mortality, including significant health disparities for black women during the postpartum period.

“Every mother in Illinois deserves access to quality healthcare following the birth of a child, regardless of their income level,” said Governor JB Pritzker. “I’m proud to announce Illinois is now the first state in the nation to offer eligible mothers 12 months of postpartum care coverage through Medicaid. This coverage expansion will further my administration’s work to reduce health disparities in communities across the state and improve maternal health outcomes for women of color.”

Women with incomes up to 208 percent of the federal poverty level will have continuous Medicaid eligibility through 12 months postpartum.

“This enhanced period of care for Illinois mothers is vital for them, their babies and their families, and is critical to reducing maternal morbidity and mortality rates and the alarming disparities in health outcomes for Black women and all women with Medicaid coverage across the state,” said Illinois Department of Healthcare and Family Services Director Theresa Eagleson. “We thank our federal partners for recognizing this great need and approving Illinois’ long-standing request.  We also thank partners in the advocacy and legislative communities who have championed women’s healthcare right alongside us.  Healthy moms equate to healthy babies and families and we are so grateful for this approval.”

Current Medicaid postpartum coverage is 60 days for women with incomes up to 208 percent of the federal poverty level.

Beyond that point, women can continue coverage with incomes up to 138 percent.

Without this newly-approved 1115 waiver, women between 139-208 percent FPL would be left uncovered in the event they develop a serious pregnancy-related illness beyond the 60-day postpartum timeframe and haven’t enrolled in new coverage yet.

For women who have enrolled in new coverage, they may have to find new in-network doctors who are not familiar with their medical history during a vulnerable time.

According to the Pritzker administration, research showed that disruptions in Medicaid coverage are common and often lead to periods of lack of insurance, delayed care, and less preventive care for beneficiaries.

For women who have enrolled in new coverage, they may have to find new in-network doctors who are not familiar with their medical history during a medically vulnerable time.

The administration said the waiver will help mothers manage chronic conditions like hypertension and diabetes and provide important access to behavioral health and other mental health care services.

An October 2018 Illinois Maternal Morbidity and Mortality Report, developed by the Illinois Department of Public Health, recommended extending continuous coverage to women for 12 months postpartum.

The report found that non-Hispanic black women are six times as likely to die of a pregnancy-related condition as non-Hispanic white women.

IDPH also found that poor continuity of care and a lack of care coordination are factors contributing to death in 93 percent of preventable pregnancy-related deaths during the late postpartum period (61-364 days postpartum).

In 2019, Governor Pritzker signed a bill into law making the change from 60 days to 12 months, and the state formally applied for the waiver from federal CMS later that year.

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