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These states have extended Medicaid coverage for new mothers

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March 1, 2023
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These states have extended Medicaid coverage for new mothers
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The Mississippi state legislature moved one step closer this week to expanding Medicaid coverage for new mothers up to a year — making it another Republican-controlled state to implement or consider the expansion.

The expansion of Medicaid has been a point of contention in GOP-majority states for years, with states such as Mississippi, Texas and Alabama refusing to accept federal incentives to expand the program at the state level. 

While 39 states have adopted the Medicaid expansion program that was laid out in the Affordable Care Act, a new program to extend coverage for those who recently gave birth has started to be adopted by a number of Republican states. 

What is the Medicaid postpartum coverage extension program?

Federal law requires states to offer pregnancy-related Medicaid coverage for eligible mothers postpartum for 60 days.

Eligibility varies from state to state, ranging from 130 percent to 380 percent of the federal poverty level. The law also requires that states offer a more narrow set of pregnancy-related coverage rather than full Medicaid coverage.

But the American Rescue Plan — a $1.9 trillion spending package signed by President Biden in 2021, amid the throes of the COVID-19 pandemic — offered states the opportunity to extend Medicaid postpartum coverage for up to a year after birth, which would include full coverage.

And as federal abortion protections fall, a number of Republican states have chosen to extend the Medicaid postpartum coverage for a full year, with some lawmakers framing it as a new “pro-life” policy platform.

Twenty-eight states have implemented the extension

There have been 28 states that have adopted and implemented the Medicaid postpartum coverage extension thus far, which is available to states for five years.

The list includes Republican states that did not even adopt the Medicaid expansion offered in the Affordable Care Act, such as Florida, Alabama, Georgia, Kansas, South Carolina and Tennessee.

The states that have adopted the postpartum coverage expansion are California, Connecticut, Hawaii, Illinois, Indiana, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Virginia, Washington and West Virginia. 

As Mississippi inches closer to adopting the expansion, Gov. Tate Reeves — a Republican who has been skeptical in the past of expanding the coverage — said this week on social media that more babies will be born due to the U.S. Supreme Court decision to overturn Roe v. Wade.

He argued adopting the postpartum coverage expansion was part of their “new pro-life agenda.”

Ten states are planning the expansion or have pending legislation to adopt the expansion

There are seven states — Arizona, Colorado, Delaware, New York, Oklahoma, Rhode Island and Vermont — that are planning to implement the expansion, according to the Kaiser Family Foundation.

Additionally, three states, including two that have not adopted general Medicaid expansion, Mississippi and Wyoming, have pending legislation to adopt the postpartum expansion. The third is Utah.

There are also three states — Missouri, Texas and Wisconsin — which have proposed or implemented partial expansions of the postpartum coverage. 

That leaves nine states — Nevada, Idaho, Montana, South Dakota, Nebraska, Iowa, Missouri, Arkansas and New Hampshire — all of which either have a Republican governor or state legislature that have not adopted the postpartum expansion.

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