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Pennsylvania plans to extend the postpartum coverage period for eligible birthing parents who are eligible for Medicaid because of their pregnancy from six months to one year.

Medicaid Postpartum Coverage

The Wolf Administration joined leadership from the Women’s Health Caucus, the Maternity Care Coalition, and the Pennsylvania Health Access Network to announce Pennsylvania’s intent to extend the postpartum coverage period for birthing parents eligible for Medicaid because of their pregnancy. This will allow thousands of birthing parents to access physical and behavioral health care that is necessary to keep themselves healthy and their families on a path to good health and well-being.

During the announcement, Department of Human Services Acting Secretary Meg Snead stated, “As our nation seeks to reverse rising trends in maternal mortality, [extended Medicaid] coverage can help us save lives and is a necessary investment in maternal-child health across Pennsylvania.”

How long is the postpartum coverage period?

Federal law requires Medicaid, or Medical Assistance in Pennsylvania, to extend eligibility for birthing parents with incomes up to 138 percent of the federal poverty level for 60 days following the birth of a baby. Under the American Rescue Plan Act, states can implement a new state plan option beginning April 1, 2022, to expand the postpartum coverage period to one year following the birth of a baby.

Why does it matter?

According to an analysis of 2018 data, the United States has the highest rate of maternal mortality among 10 similar nations. Data for 2019 shows that the trend is growing – up to 20.1 deaths per 100,000 live births from 17.4 per 100,000 in 2018. Maternal mortality is significantly more common among Black women as compared to White and Latinx women in the United States.

Medicaid covers four in 10 births nationally and about three in 10 in Pennsylvania and was the primary payer in Pennsylvania in about 53 percent of pregnancy-associated deaths. Nearly 60 percent of all pregnancy-associated deaths came between six weeks and one year after giving birth, largely outside of the 60-day limitation on coverage.

When will the expansion take effect?

The postpartum expansion will be available to states to take effect in April 2022. A formal declaration of intent to expand the postpartum coverage period will be submitted to the federal government once guidance is issued to states from the Centers for Medicare and Medicaid Services.

More Information

For the full press release, visit the Pennsylvania Pressroom website. To apply for Medical Assistance and other assistance programs, visit: www.compass.state.pa.us. For more news, visit our News page.