HHS Approves 12-month Extension of Postpartum Medicaid and CHIP Coverage in Hawaii, Maryland, and Ohio

By U.S. Department of Health & Human Services

An estimated additional 34,000 people are now eligible for essential care for a full year after pregnancy, thanks to the American Rescue Plan and the Biden-Harris Administration’s efforts to strengthen maternal health coverage.

Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), approved the extension of Medicaid and Children’s Health Insurance Program (CHIP) coverage for 12 months after pregnancy in Hawaii, Maryland, and Ohio. As a result, up to an additional 34,000 people annually - PDF – including 2,000 in Hawaii; 11,000 in Maryland; and 21,000 in Ohio – will now be eligible for Medicaid or Title XXI-funded Medicaid expansion CHIP coverage for a full year after pregnancy. With today’s approval, in combination with previously approved state extensions, an estimated 318,000 Americans annually in 21 states and D.C. are eligible for 12 months of postpartum coverage. If all states adopted this option, as many as 720,000 people across the United States annually would be guaranteed Medicaid and CHIP coverage for 12 months after pregnancy.

The Biden-Harris Administration has made expanding access to high-quality, affordable health care a top priority – and because of the American Rescue Plan (ARP) and other Administration efforts, more people than ever before have health insurance coverage. Extending Medicaid postpartum coverage is an important part of these efforts.

“Thousands of families in Hawaii, Maryland, and Ohio will now be able to access the health care they need for a full year after pregnancy,” said HHS Secretary Xavier Becerra. “The Biden-Harris Administration has made strengthening maternal health a top priority – and extending postpartum coverage not only improves health outcomes, but saves lives. Thanks to President Biden’s American Rescue Plan, now more than 318,000 families across the country can have the peace of mind that comes with essential health care coverage. We applaud Hawaii, Maryland, and Ohio for joining our efforts to support healthy parents and babies and urge all other states to work with us in expanding access to this critical care.”

The Biden-Harris Administration has championed policies to improve maternal health and equity since the President and Vice President first took office. In April 2021, President Biden issued the first-ever Presidential Proclamation marking Black Maternal Health Week. In December 2021, Vice President Harris hosted the first-ever White House Maternal Health Day of Action, where she announced important commitments to address the maternal health crisis. The Vice President also issued a Call to Action to the private and public sector to improve maternal health outcomes, where she urged states to extend Medicaid coverage for postpartum women from 2 months to 12 months and announced guidance for how states can extend their coverage. Additionally, she convened a historic meeting with Cabinet Secretaries and agency leaders to discuss the Administration’s whole-of-government approach to addressing maternal mortality and morbidity. Today’s announcement is part of HHS’ ongoing effort to support safe pregnancies and childbirth, eliminate pregnancy-related health disparities, and improve health outcomes for parents and infants across our country.

In June, the White House released the Biden-Harris Administration’s Blueprint for Addressing the Maternal Health Crisis, a whole-of-government approach to combatting maternal mortality and morbidity. For far too many people, complications related to pregnancy, childbirth, and the postpartum period can lead to devastating health outcomes and result in hundreds of deaths each year. This maternal health crisis is particularly devastating for Black and American Indian and Alaska Native people, and those in rural communities, who all experience maternal mortality and morbidity at significantly higher rates than their white and urban counterparts.

In July, CMS released its Maternity Care Action Plan to support the implementation of the Biden-Harris Administration’s Blueprint, which includes postpartum coverage extensions through Medicaid and CHIP. The action plan takes a holistic and coordinated approach across CMS to improve health outcomes and reduce disparities for people during pregnancy, childbirth, and the postpartum period. CMS’ implementation of the action plan will support the Biden-Harris Administration’s broad vision and call to action to improve maternal health.

“Hawaii, Maryland, and Ohio now join an ever-growing cadre of state partners supporting the promise that comes with health care coverage in the critical first year after pregnancy,” said CMS Administrator Chiquita Brooks-LaSure. “The American Rescue Plan forms the bedrock for this opportunity, and gives states the foundation to support the health and well-being of postpartum women and families. Now, as part of CMS’ Maternity Care Action Plan, we’re putting even more gears into motion to make improved maternal health a reality for communities across the country.”

This extension of coverage was made possible by a new state plan authority established by the ARP, under which states may extend postpartum coverage in their Medicaid and CHIP programs from the current mandatory 60-day period to 12 months. Hawaii, Maryland, and Ohio are the latest states to extend Medicaid and CHIP coverage for 12 months following pregnancy, joining the following states that received approval under either the ARP state plan option or section 1115 demonstration authority: California; Connecticut; Florida; Illinois; Kansas; Kentucky; Louisiana; Maine; Massachusetts; Michigan; Minnesota; New Jersey; New Mexico; Oregon; South Carolina; Tennessee; Virginia; Washington state; and Washington, D.C. CMS continues to work with states that have proposed adopting the ARP option to extend postpartum coverage to 12 months.

Medicaid covers 42% of all births in the nation. This new option for states to extend Medicaid and CHIP postpartum coverage is part of the ongoing efforts of HHS and the Biden-Harris Administration to address disparities in maternal health outcomes by opening the door to postpartum care for hundreds of thousands of people.

As noted in a report - PDF published by the HHS Office of Assistant Secretary for Planning and Evaluation, one in three pregnancy-related deaths occur between one week and one year after childbirth. The postpartum period is critical for recovering from childbirth, addressing complications of delivery, ensuring mental health, managing infant care, and transitioning from obstetric to primary care.

Visit Medicaid.gov to learn more about the Medicaid state plan amendment extension of postpartum coverage in Hawaii, Maryland, and Ohio.