The Wisconsin Department of Health Services (DHS) is seeking public comment for its draft waiver request to the Centers for Medicare & Medicaid Services (CMS) to extend postpartum Medicaid coverage for an additional 30 days. 2021 Wisconsin Act 58 requires DHS to submit an application for a federal Medicaid Section 1115 demonstration project to extend the duration of postpartum coverage to the last day of the month 90 days after the last day of pregnancy.
DHS is soliciting comments through May 6, 2022. Written statements can be submitted using one of the following methods:
- Email: firstname.lastname@example.org
- Fax: 608-266-1096
Department of Health Services, Division of Medicaid Services
Attn: Wisconsin 1115 Postpartum Coverage Waiver
PO Box 309
Madison, WI 53707-0309
WHAT YOU CAN DO:
If you are interested, please consider submitting a letter by May 6, 2022. This need not be lengthy – keep it to less than a page. Here are some suggestions and resources for clear, concise, conversational, and compelling letters:
- Introduce yourself and your expertise in the area
- Be specific about why you are writing, select one or two talking points to highlight, ACOG. Talking Points: Extending Medicaid Coverage for Pregnant Women
- Include a brief story from your experience
- Consider thanking DHS for requesting an extension for 90 days of coverage, and remind them that 1 year is the goal and recommendation of health professionals
- Here’s a sample letter you can use from the WI Association for Perinatal Care: Your Voice Matters when It Comes to Extending Postpartum Medicaid Coverage – Wisconsin Association for Perinatal Care (perinatalweb.org)
- Lawmakers blew chance to help new mothers and address the racial gap. Cap Times, WI Alliance for Women’s Health
- 2017 Annual Wisconsin Birth and Infant Mortality Report www.dhs.wisconsin.gov/publications/p01161-19.pdf
- MOD2019-POLICY-ACTIONSv5.pdf (marchofdimes.org)
BACKGROUND: The 2021 American Rescue Act Plan of 2021 gave states a new option to extend Medicaid postpartum coverage from 60 days to 12 months. In Wisconsin, a bipartisan bill (SB 562) was introduced in the state legislature but failed to pass in March. The Governor’s budget included extension of Medicaid for one year postpartum, however the legislature only approved a wavier application to extend Medicaid from 60-90 days postpartum.
WHY THIS IS SO IMPORTANT: The postpartum period is a critically important, yet often neglected, time in the health of the birthing person and baby. Pregnancy-related medical conditions, chronic health conditions, and even death can occur in the months following birth or the end of pregnancy. Wisconsin data for 2017 indicated that 41% of birthing people had one or more medical risk factors that put them at higher risk for pregnancy complications or poor birth outcomes. Pregnancy-related medical and chronic health conditions left untreated can have serious consequences if the birthing person cannot care for themselves and their baby. Over three quarters of maternal deaths occur in the postpartum period and the vast majority are preventable.
Racial disparities in the health of birthing people and their babies are of particular concern. In Wisconsin, a Black birthing person is five times more likely to die of birthing mortality than a white birthing person. Nationally, Black, American Indian, and Alaska Native birthing people are two to three times more likely to die from pregnancy-related causes than non-Hispanic white birthing people. Extending Medicaid coverage during the postpartum period is emerging as a critical strategy to address disparities in morbidity and mortality of birthing people.
WHO IS IMPACTED?
- Under current law, the income eligibility threshold for pregnant people is 300% of the federal poverty level ($6,937.50 monthly for a family of 4). Eligibility for coverage ends on the last day of the month when the 60-day postpartum period ends.
- Unless eligible under other Medicaid provisions, birthing people above that level are no longer eligible for coverage. They are disenrolled from the program after 60 days, causing disruptions to care and access to coverage
- Birthing people whose household income is below 100% of the FPL ($2312.50 monthly for a family of 4) may retain eligibility following pregnancy, as either a parent or a childless adult (if they are not a parent of a child in the household)