CMS: Virginia Will Expand Access to Postpartum Medicaid Coverage

CMS announced that Virginia is expanding its postpartum Medicaid coverage.

“It is a privilege to partner with the Commonwealth of Virginia to expand access to life-saving postpartum coverage and care,” said CMS Administrator Chiquita Brooks-LaSure. 

“Today’s action advances our commitment to improving the health of low-income pregnant people and their babies and preventing pregnancy-related illness and death.”

The state of Virginia implemented this expansion by amending the Virginia Family Access to Medical Insurance Security (FAMIS) MOMS and FAMIS Select Demonstration, a section 1115 demonstration. Under the expanded coverage, enrollees who have given birth will be able to have coverage for a full year or regain Medicaid coverage within a year.

The expansion will also have a retroactive element. It will extend coverage to eligible individuals who have exceeded Virginia’s original 60-day postpartum coverage period but have not yet exceeded a year after childbirth. 

However, the year for coverage still starts when the postpartum coverage period usually starts, so eligible individuals may not receive a full year of coverage. Instead, they will only receive coverage for the amount of time that is left in the year after childbirth.

The changes to Medicaid coverage will take effect starting November 18, 2021.

The Virginia Family Access to Medical Insurance Security (FAMIS) MOMS and FAMIS Select Demonstration functions in tandem with the efforts to improve access to maternal care in the American Rescue Plan, which established a similar expansion strategy.

“Becoming a parent is among life’s greatest milestones, but sadly paired with significant challenges for many in low-income communities,” said Health and Human Services Secretary Xavier Becerra. 

“I applaud Virginia for taking action to provide vital, continued care for new parents and their precious newborns. This expansion of postpartum coverage will not only improve health outcomes for thousands of Virginians— it will save lives. The Biden-Harris Administration encourages more states across the country to adopt this expansion and support healthy parents and babies.”

The move is expected to impact 6,000 Virginia residents. It will be especially crucial for minority communities, in which access to maternal care can be challenging.

“Improving maternal health outcomes—particularly among underserved communities, including among people of color—is a top priority for the Biden-Harris Administration,” Administrator Brooks-LaSure said.

Earlier in 2021, Illinois also targeted maternal health, specifically for mothers in rural regions and among Black communities. Like Virginia, the midwestern state leveraged the flexibilities set forth in the American Rescue Plan to expand postpartum coverage to a full twelve months. Approximately 2,500 mothers in Illinois gained access to postpartum Medicaid coverage as a result.

At the time, Secretary Becerra emphasized the impact of continuous healthcare coverage on patient outcomes, not only on new mothers but also on infants. These efforts are also essential to improving health equity.

Maternal healthcare for both the prenatal and postpartum periods has also been a key focus for commercial payers in 2021. For example, only a month preceding Virginia’s section 1115 demonstration announcement, UnitedHealthcare revealed that it would be providing $175,000 to UWH of North Carolina to support prenatal care for pregnant persons.

These announcements come with the advent of sobering news regarding maternal healthcare.  UnitedHealth Group America’s Health Rankings report uncovered that women and children’s behavioral and physical health, as well as their insurance rates, have been suffering despite certain improved health habits.

Maternal mortality escalated 16 percent over the course of a single year from 2018 to 2019. More than six women died for every 1,000 births.

Moreover, one in three new mothers continues to face uninsurance at some point during their pregnancies, despite Medicaid expansion. Hispanic women in particular were more susceptible to being uninsured during their pregnancies than Black women or White women.

These contextual details of rising maternal mortality and unstable insurance coverage are only a couple of examples of why states and payers are reworking their approach to maternal healthcare and insurance.