Governor J.B. Pritzker’s office announced today that that Illinois is the first state in the nation to extend full Medicaid benefits from 60 days to 12 months postpartum, following the federal Centers for Medicare & Medicaid Services approval of Illinois’ 1115 waiver allowing for the extension.
In an announcement from the governor’s office, Pritzker says that he extension of Medicaid postpartum benefits to 12 months will strengthen continuity of care to improve health outcomes for new mothers in Illinois and is aimed at reducing the rate of maternal morbidity and mortality, including significant health disparities for women of color during the postpartum period.
Women with incomes up to 208% of the federal poverty level will have continuous Medicaid eligibility through 12 months postpartum, a significant increase in coverage from the standard 60-day postpartum period. Current coverage is for 2 months, and beyond that point, women can continue coverage with incomes up to 138% of the federal poverty level. The new waiver will now protect those between the 208-138% poverty level range in the event they develop a serious pregnancy-related illness beyond the 60-day postpartum time frame and haven’t enrolled in new coverage yet. According to the announcement, for women who have enrolled in new coverage in the past, they would have had to find new in-network doctors who were not familiar with their medical history during a vulnerable time.
The govneror’s announcement says the continuity of coverage available through the waiver approval will help mothers manage chronic conditions like hypertension and diabetes and provide important access to behavioral health and other mental health care services.
An October 2018 Illinois Maternal Morbidity and Mortality Report, developed by the Illinois Department of Public Health recommended extension of the coverage. The report found that Non-Hispanic Black women are six times as likely to die of a pregnancy-related condition as non-Hispanic white women. IDPH also found that poor continuity of care and a lack of care coordination are factors contributing to death in 93% of preventable pregnancy-related deaths during the late postpartum period.
In 2019, Pritzker signed a bill for the extension of the coverage and the state applied for the waiver with the federal government later that same year. According to an announcement by U.S. Health & Human Services Director Xavier Beccera on Monday, the waiver will go into effect immediately and will remain in effect until December 31st, 2025. The program is expected to effect approximately 2,500 new moms in the state.
Becerra also unveiled that $12 million will be made available over four years for the Rural Maternity and Obstetrics Management Strategies program. Those who earn RMOMS funding will work toward models and strategies to improve access to maternal health care in rural areas and will be required to focus on populations that “have historically suffered from poorer health outcomes, health disparities and other inequities.” Three winners will get up to $1 million every year for up to four years.