“More than half of pregnancy-related deaths occur in the 12-month postpartum period, many of which are preventable,” Ohio Department of Medicaid Director Maureen Corcoran said while announcing of the program this week. “Women who have recently given birth have health needs that continue for a full year, and high-risk pregnancy-related complications such as preeclampsia, blood clots, and heart problems may not appear until months after delivery.”
Medicaid covers about half the births in Ohio. That’s because women can have an income above the typical Medicaid cutoff — 200% of the federal poverty level — and still qualify during pregnancy.
Previously, the criteria went back to the typical limits at 60 days after birth. But that cutoff often meant a disruption in provider relationships and disruption in care still being received.
Locally, a majority of the patient population seeking pediatric-related care through Rocking Horse Community Health Center in Springfield are Medicaid-eligible, said pediatric nurse practitioner Abby McNeil. She estimated that she sees roughly 600 Medicaid-eligible patients annually.
The extension of Medicaid eligibility benefits both new mothers and their infants, she said.
“It will help give parents the ability to continue to see their providers regularly,” she said. “We’re able to touch base with families more often, as needed, because there are less constraints on these parents and they have more support through the Medicaid expansion.”
When the American Rescue Plan passed, it included federal support for states that expand eligibility for Medicaid coverage for women until their baby’s first birthday, and Ohio took the chance to expand the program.
Several maternal health advocacy groups have supported this change, saying it could help address the complex problems that drive maternal mortality and severe maternal morbidity in Ohio.
When Ohio released in 2019 its first report in years on maternal mortality, it found over half of pregnancy-related deaths in Ohio were preventable. Black women died at a rate more than two and a half times that of white women.
The leading causes of death related to pregnancy in Ohio from 2008 to 2017 were cardiovascular and coronary conditions at 14%, followed by infections at 13%, hemorrhage 12%, mental health conditions at 11%, pre-eclampsia and eclampsia at 10%, according to Ohio Department of Health data.
New mothers will also get better maternal health treatment under the expansion, McNeil said. That’s because In addition to physical recovery post-birth, the expansion includes behavioral healthcare, such as services related to postpartum depression.
“These mothers need support, and oftentimes postpartum symptoms don’t even present until maybe a month, could be two months after birth,” McNeil said. “Those mothers need follow-up, counseling, things of that nature.”
The new option took effect April 1 for Ohio. After five years, the state can decide whether to renew.
By the numbers: Ohio Medicaid
14,000: Estimated number of women each year that Ohio Medicaid estimates will continue eligibility through the extended postpartum coverage
200% of the federal poverty level: Medicaid pregnancy and postpartum coverage eligibility limit
731: Pregnancy-associated deaths in Ohio from 2008 to 2018. 30% were pregnant at time of death, 20% were pregnant within 42 days of death, and 50% were pregnant within 43 to 365 days of death
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