Federal Medicaid officials announced an extension of postpartum coverage and expanded eligibility for people who may have trouble accessing public health coverage along with rule changes aimed at improving obstetric care at key hospitals and increasing access to care for underserved communities.
The updates, announced in mid-July, along with the White House’s Blueprint for Addressing the Maternal Health Crisis are part of a broader effort to reduce pregnancy and birth-related deaths in the U.S., where rates far exceed other highly developed nations.
Maternal Deaths are Unequally Distributed – and Most are Preventable
While maternal mortality rates have declined since the spikes during the COVID-19 pandemic, provisional data from the CDC show that around 680 women died in childbirth in 2023. Such deaths are more common among American Indian, Alaska Native and Black mothers, who also experience higher disparities in access to pre- and post-natal care.
But research shows more than 80% of maternal deaths are preventable.
Ensuring hospitals meet minimum safety and care standards is one change that could make a difference. This is especially important for those facilities designed as “critical access” for their service to high-risk populations. The changes announced last month proposed closer tracking of staffing, training, emergency preparedness, care delivery and cultural competencies of these hospitals.
Officials expect the changes to “improve the safety, quality and timeliness of the care that hospitals provide to pregnant women.”
Expanded Access and New Outreach
Last month’s announcement also outlined exceptions to the federal “four walls rule,” which prohibits Medicaid from reimbursing for services provided outside of the facility. This change is designed to encourage outreach to mothers in very rural areas, including those served by the Indian Health Service and tribal area clinics who may require follow-up postpartum care.
Mothers who were previously incarcerated will also see their access to covered care improve under the new rules.
The recently announced changes, along with other government and community-led efforts, have the potential to move the country off the bottom rung among its peers regarding maternal mortality.
