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Postpartum Medical Coverage

April 4, 2022
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WRITTEN BY Dr. Jill Barnas

Executive Summary

The Centers for Disease Control and Prevention (CDC) defines maternal mortality as the pregnancy-related death of a woman while pregnant or within one-year postpartum for any cause related to or aggravated by pregnancy. In recent years, the Missouri maternal mortality rate has been higher than the national rate and is one of the highest in the country. Low-income pregnant and postpartum women in Missouri receive benefits through MO HealthNet or Show-Me Healthy Babies throughout pregnancy and for 60 days postpartum.  Filed in the 2022 Missouri Legislative Session, SB 639, SB 698, HB 2604, and HB 2644 expand postpartum medical care coverage from 60 days to one full year following the end of pregnancy, which has authorization for 5 years of funding to support the expansion under the federal American Rescue Plan Act of 2021. 

Highlights

  • The maternal mortality rate in Missouri (33 deaths per 100,000 live births) is significantly higher than the national rate (23.8 deaths per 100,000 live births).
    • Black Missourians are at four times greater risk for maternal mortality than White Missourians.
  • MO HealthNet for Pregnant Women and Show Me Healthy Babies program provide postpartum coverage for 60 days after pregnancy. 
    • Approximately two-thirds of maternal deaths in Missouri occur between 43 days to one year postpartum.
  • Medicaid expansion has been associated with improved access to maternal care, improved chronic disease management while pregnant, and a reduction in overall and minority maternal mortality rates. 

Limitations

  • It is unknown how extending postpartum coverage will impact compliance with infant outpatient visits and follow-ups in the first year of development.
  • Maternal mortality in Missouri has only recently been thoroughly investigated by the state. Therefore, it is challenging to identify areas of improvement, problems with quality care, and other social determinants of health without more data.
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