Preventable deaths are a major issue in the U.S. healthcare system, and maternal mortality is one very concerning contributor. For instance, four out of five pregnancy-related deaths are avoidable. Just recently, a medical examiner’s report showed that Olympic medalist Tori Bowie tragically died from childbirth complications. Despite being one of the richest nations in the world, the U.S. has double the number of maternal deaths compared to other developed countries. This is the dangerous reality of being a pregnant person in the U.S.
When you parse the data by race, Black and American Indian/Alaskan Native people are disproportionately impacted in this crisis. As a second-year medical student considering a specialty in obstetrics and gynecology, I feel distraught by what is in store for my future patients. As healthcare professionals, we have a duty to advocate for policies that protect our patients. We can and must take action now. One policy that has the potential to turn this around is making the 12-month postpartum Medicaid coverage available in all states, an option currently available through the American Rescue Plan Act and Consolidated Appropriations Act.
Thirty-six states and the District of Columbia have already taken advantage of this option to extend coverage for 12 months, with seven states planning on passing such legislation and two states passing more limited legislation. Texas was the latest state to join this list, with the governor signing legislation in mid-June. However, as the Medicaid continuous enrollment provision is winding down, many postpartum individuals are at risk of losing their coverage. While there are other insurance plans available that provide such coverage, the challenges of being a new parent and the confusing insurance market can be overwhelming. A recent Kaiser Family Foundation report highlights this concern and urges states to act.
Why is coverage for 12 months postpartum important? Data shows that over half of pregnancy-related deaths happen between a week and a year after giving birth. Inconsistent Medicaid coverage for pre- and postpartum people builds barriers to needed care during this time. If pre- and postpartum people cannot afford to visit their healthcare provider when symptoms, like high blood pressure and depression, first arise, providers are fighting an uphill battle when things take a turn for the worse. However, the 12-month extension can help address these issues. Nearly 720,000 Americans would be eligible for additional Medicaid coverage during the postpartum period if all 50 states and Washington, DC passed this legislation. However, many Americans are getting left behind in the states with no plans and those with limited coverage.
In my recent medical training, I worked in an outpatient clinic in Ohio where I saw many pregnant patients receive the care they need and deserve. But I also saw some patients with insurance, transportation, and language barriers that prevented them from keeping their prenatal and postpartum appointments. While the clinic is lucky to be able to provide support for some patients — such as providing in-person translators or calling a transportation service repeatedly for hours to get one patient picked up — we only have so many resources. This means that some patients are unfortunately left behind when they deserve full access to healthcare.
We must take action to prevent maternal mortality in this country. Whether you’re a healthcare professional or not, you likely know someone in your life that suffered from a postpartum period with excessive bleeding, infections, breastfeeding complications, depression, or other serious medical conditions. Therefore, I urge everyone to call or email their legislators today (find their contact info here). Use your constituent power to make the 12-month Medicaid postpartum coverage policy a reality in your state, and give vulnerable pregnant and postpartum patients a chance to avoid the fate of Tori Bowie and so many others.
Alex Grayson is a rising second-year medical student at the University of Cincinnati College of Medicine.
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