Prioritizing mothers and extending medicaid for postpartum women in Texas

In 2020, over 368,000 babies were born in Texas. That’s about one baby every 90 seconds. Medicaid, the joint federal and state program that provides health care coverage for low-income people, covers about 50% of those births. 

Medicaid coverage is a lifeline for low-income pregnant women across the state. But in the quest to reduce maternal mortality, a goal that 60% of Texans believe should be a top priority for the Legislature, we can do more. 

Today, Medicaid for pregnant women in Texas ends two months postpartum, but 27% of maternal deaths occur beyond 43 days postpartum. Extending postpartum Medicaid coverage to 12 months, as House Bill 12 by Rep. Toni Rose and Sen. Lois Kolhorst proposes to do, allows women to maintain access to their doctors and their health care network. The stakes for doing so could not be higher. In 2019, 118 Texas women died as a result of pregnancy

The causes of maternal mortality vary widely. Hemorrhage is the most likely cause during pregnancy and childbirth, while deaths from heart conditions and mental health-related conditions, including substance use and suicide, are most common in the postpartum period.

The Texas Department of State Health Services has released disturbing data that underscores the risks and disparities faced by many women giving birth in our state. Black mothers experience severe maternal morbidity rates — defined as severe childbirth complications causing serious risk for long-term health problems — that are more than twice as high as their white counterparts.  

Additionally, according to Texas 2036’s multi-year uninsured project, 42% of uninsured Texas women constantly worry about affording necessary health care. Across Texas, seven out of 10 women aged 20-64 are part of the workforce, with an average annual paycheck of $45,600. This financial strain not only impacts their physical well-being but also takes a toll on their mental health, with 36% postponing mental health care due to cost concerns. 

The continuous Medicaid eligibility requirements that the federal government implemented as part of the COVID public health emergency allowed women to keep their postpartum coverage for up to three years and has provided a test case for the effects that 12 month eligibility has for Texas women. 

The Parkland Community Health Plan found that those women who remained on Medicaid for 12 months postpartum sought mental health and substance use treatment at a rate three times that of women who lost coverage after two months. Those with continuous coverage also used 37% fewer services in the first postpartum year following subsequent pregnancies. 

By joining the 33 other states that have implemented 12-month postpartum coverage, we can save lives, provide adequate care for new mothers, reduce disparities and improve the health outcomes for mothers across the state.

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