Ohio moms will soon have greater Medicaid coverage for postpartum care

Maeve Walsh / March 29, 2022

COLUMBUS, Ohio (WCMH) – Had Marian Dancy not called the doctor referral number on the back of her insurance card, she could have died from heart failure.

Six months after giving birth to her fourth child in May 2019, Dancy, 37, of Whitehall, said she was diagnosed with peripartum cardiomyopathy, a potentially life-threatening weakness of the heart that typically occurs during the last trimester of pregnancy or within one to five months of childbirth.

By the time she met with a fourth doctor during the week of Thanksgiving in hopes of diagnosing her symptoms, Dancy said her ejection fraction, which measures how much blood your heart is pumping, was at 15 percent.

“At that point, my symptoms had gotten so severe I could barely walk. I walked into the bathroom – I was severely out of breath, feeling like I was going to pass out; I hadn’t laid down flat in weeks because my lungs, what I found out, my lungs were filled with fluid, and I had no idea,” she said.

An ejection fraction considered normal, according to the American Heart Association, is 50 to 75 percent – meaning Dancy was at severe risk of heart failure, she said.

“She (the doctor) looked at me, her nurse looked at me, they ran a few tests,” Dancy said. “And she said, ‘How did you make it in here today? Like, this is what I’m seeing from you. I think that we have a case of heart failure.’ And it was a shock. It was a shock.”

For doctors, maternal patients, and their children alike, a new five-year provision included within the now-enacted House Bill 110, passed in June 2021, will help prevent pregnancy-related diseases from spiraling out of control.

Beginning April 1, new mothers in Ohio who are insured through Medicaid will receive postpartum care benefits for 12 months after a pregnancy – up from the original 60 days provided to recent mothers, according to American Heart Association state government relations director Dustin Holfinger.

In total, Holfinger said the Medicaid extension will cost about $15 million each fiscal year, with $11 million coming from federal funds provided through the American Rescue Plan Act and $4 million coming from the state.

“Many women on Medicaid, you know, they only get coverage till maybe that 60 days,” said Dr. Laxmi Mehta, section director of preventative cardiology and women’s cardiovascular health at Ohio State’s Wexner Medical Center. “And there’s still this high-risk window of maternal complications that can occur, with cardiovascular disease being the number one killer of women.”

While Mehta said cardiovascular disease is the number-one killer of new moms in the U.S., postpartum patients are at risk of developing a slew of other health issues like mental health disorders, anemia, and high blood pressure, according to the Centers for Disease Prevention and Control.

But, without insurance coverage past the 60-day timeframe, Mehta said women on Medicaid are at greater risk of going untreated for underlying health conditions that otherwise could have been addressed at preventative doctor visits. 

“The toll that pregnancy takes on your body is huge,” Dancy said. “And it’s important to have that support and know that, ‘Hey, if something comes up in this period, I still have coverage, I won’t have to worry about will this be covered?’”

Although Dancy was covered under private health insurance, she said a Medicaid patient diagnosed with the same cardiovascular disease at six months post-pregnancy would likely have had to pay out-of-pocket costs – an insurance bill she said she couldn’t imagine.

Not only did Dancy incur costs from multiple doctors and emergency room visits, but she was also admitted to a two-week hospital stay and underwent cardiac therapy, she said.

“Just knowing that the cost of health care, I mean, it would have been devastating for my family if I had to pay out of pocket,” Dancy said.

While Mehta said the five-year Medicaid extension is a step in the right direction, she said more needs to be done to ensure Ohio women have access to health care to prevent pregnancy-related diseases, which disproportionately impacts Black women and women of color.

Mehta said it’s important that hospitals are adequately equipped to care for women at risk for developing postpartum complications, like implementing improvements to IT systems to identify high-risk patients and increasing awareness within the medical community about warning signs to look out for.

“There’s other aspects that, you know, are important, and one year is great because that’s the highest risk, but how do we get these women to have health care throughout their lifetime?” Mehta said. “It’s beyond the scope of this bill.”

Despite the fear and stress that followed her life-threatening diagnosis, Dancy said she is beyond grateful for her insurance coverage and the lessons that it’s taught her family of six.

“It just allowed us to reflect and really reprioritize our health, the way we live life, all the things that contribute – emotional health, physical health, all of it in conjunction with each other,” she said. “So we just kind of just reprioritize and it’s like, we don’t take anything for granted.”