Wisconsin Public Radio

Bipartisan Bill Would Extend Postpartum Medicaid Coverage

Increasing healthcare access could help address racial health disparities.

By , Wisconsin Public Radio - Dec 9th, 2021 11:15 am
Wisconsin State Capitol. Photo by Mariiana Tzotcheva.

Wisconsin State Capitol. Photo by Mariiana Tzotcheva.

bipartisan bill before the state legislature would extend Wisconsin’s postpartum Medicaid coverage to a full year after giving birth.

Under current law, pregnant people in Wisconsin qualify for Medicaid, or BadgerCare, if they earn up to three times the federal poverty level — $52,260 for a family of two (including the unborn child) or $65,880 for a family of three. But that coverage only lasts for 60 days after birth.

After the coverage period ends, the qualifying income level drops back down to below the federal poverty limit — $17,420 for a family of two or $21,960 for a family of three.

“Since situations don’t always arise within those first 60 days, extending the access to postpartum care can allow new mothers to benefit from instruction about management of chronic health conditions, behavioral health conditions, in addition to recovery from childbirth and pregnancy complications,” said state Sen. Joan Ballweg, R-Markesan, a lead sponsor of the bill.

The United States has the highest maternal mortality rate of any developed nation. Each year about 700 people die as a result of pregnancy or delivery complications. Non-Hispanic Black women are about three times more likely to die than white women. And in Wisconsin the disparity is even greater — Non-Hispanic Black mothers die at five times the rate of white mothers.

“We have a problem with equity in our state. And we need interventions that are going to help reduce this gap,” said Dr. Amy Domeyer-Klenske, vice chair of the Wisconsin section for the American College of Obstetricians and Gynecologists. “I want all of my patients to have that same opportunity to improve their health and lives in the postpartum period so they can raise healthy children.”

Gov. Tony Evers pushed for a full year of coverage in his 2021-23 budget proposal. The Republican-controlled Legislature agreed to add 30 days, extending the total coverage to three months. But the state still needs to get those extra 30 days approved through a federal waiver — a labyrinthine process that advocates said can take years.

But the American Rescue Plan Act of 2021 gave states a simpler path to extend coverage. Starting in April 2022, states have a five-year window in which to extend their postpartum Medicaid coverage to a full year without having to go through the formal waiver process. But it has to be a full year — Wisconsin’s extra 30 days won’t cut it.

And Domeyer-Klenske said 30 days is just an arbitrary time period. The child is already covered for at least a year after birth, so advocates say it only makes sense that the mother would be as well.

“To have a healthy baby, it requires a healthy parent,” said Domeyer-Klenske.

Postpartum coverage gives people time to heal after delivery and manage pregnancy-related conditions like diabetes and heart conditions. But it can also cover counseling for things like breastfeeding and planning for future pregnancies.

Domeyer-Klenske said it’s common for people to struggle with mood disorders after giving birth. She said these conditions don’t go away after only 60 days.

“But then we take that treatment away. So now we have a person who is struggling with depression and anxiety, and we’re expecting them to care for a new infant? Not all of these individuals have support at home. So, what does happen to that baby when you don’t have a parent who is healthy to really care for them?” said Domeyer-Klenske.

And even for the healthiest of people, changing insurance is never a pleasant experience, said state Rep. Amy Loudenbeck, R-Clinton, a lead sponsor for the bill.

“Can you imagine being a single mom at 60 days and having to change providers, fill out a bunch of forms? I just can’t even imagine making that a priority,” said Loudenbeck. “You don’t have to be a mom to think that this is good policy.”

And the bill does have a tremendous amount of support on both sides of the aisle. Of the 13 Senate sponsors and coauthors, six are Republicans and seven are Democrats. And in the Assembly, the 32 supporters are split evenly between the two parties.

At a public hearing for the Senate bill in October, 32 organizations registered in favor of the bill, with only one registering in opposition.

And there is momentum at the federal level, as well. The current version of the Build Back Better bill would extend postpartum Medicaid coverage to a full year for all states. But passage of the bill is not a done deal. And both Loudenbeck and Ballweg said they would rather this was something Wisconsin chose for itself.

“I would prefer that Wisconsin would take that step and be proactive in doing this and not wait for anything that’s happening on the federal level,” said Ballweg.

Loudenbeck said the Assembly version of the bill will likely have a public hearing early next year. And Ballweg expects a committee executive vote on the Senate version by January.

Both are hopeful that the legislation will pass.

“There’s just so much good that can come with a healthy mom being able to take care of their newborn in their first year of life,” said Ballweg.

Bipartisan bill would extend postpartum Medicaid coverage in Wisconsin to a year after giving birth was originally published by Wisconsin Public Radio.

One thought on “Bipartisan Bill Would Extend Postpartum Medicaid Coverage”

  1. NieWiederKrieg says:

    Americans are considered barbaric compared to Germans when it comes to child birth… Both the German mother AND THE FATHER are given lengthy periods of paid time off, up to 14 months, to care of their baby…

    Parental leave in Germany
    Germany is keen to encourage parents to have children as a way of addressing under-population issues – women have 1.6 children on average.

    A parent who interrupts his or her career to raise a child receives 67% of their last net income (up to €1,800 per month). The Elterngeld (parental allowance) payment ranges from a minimum of €300 to a maximum of €1,800 per month. This benefit lasts for one year, which can be extended to 14 months if the second parent likewise stays at home for at least two months. The aim is to allow both parents to take time off.

    Parents also have the legal right to take up to three years leave from work. During this time a parent can receive a reduced monthly allowance from the government. Furthermore, as long as there are no valid company reasons against it, parents can choose to work part-time. Other benefits are offered to mothers, such as nursing breaks and restrictions on overtime or evening hours.

    The government has also introduced the ElterngeldPlus package with the aim to help parents who work part-time following the birth of their baby in Germany. This offers additional financial support options. Read more family policies on the government website.

    German maternity leave
    Following the standard five days stay in the hospital, women who give birth in Germany receive 14 weeks of paid maternity leave. This is broken into six weeks before the expected birth date and eight weeks after. The initial six weeks of maternity leave in Germany provides the mother with time to mentally and physically prepare for giving birth. The final eight weeks allows her to recover, get settled at home with her new child, and allow for the midwife to visit.

    Paternity leave in Germany
    The law enables both parents to take time off should they wish to, enabling fathers to also pause their careers to raise a child and claim a reduced income. If a father’s employer agrees, he may also choose to work part-time for a certain period if desired, while taking parental leave in Germany.

    Childcare and benefits in Germany
    The monthly child benefit in Germany is €190 for the first and second child, €196 for the third, and €221 for every other child under the age of 18. For more information regarding child benefit in Germany, including the application form, visit the Bundesagentur Fur Arbeit (Federal Agency for Work) website.

    There are a wide range of childcare options in Germany but costs and availability vary. Typically, care for ages up to three years old will be with childminders, a nanny or other in-home care, or in a private nursery. Since legalization in 2013, children aged from 12 months have a legal right to a childcare place, which will be partly subsidized by the state. Children age three to six are also entitled a place in a German preschool, known as kindergarten, and some after-school clubs. School-aged children (6+) have the additional option of wrap-around care at school, although not all schools provide this. Read Expatica’s detailed guide to childcare in Germany.


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