January 13, 2022

Medicaid coverage could be extended to 12 months for postpartum care

The New Mexico State Capitol, or Roundhouse Wikicommons.

New Mexico could expand Medicaid coverage for postpartum care from two months to a full year starting this spring.

The New Mexico Human Services Department is working to have the new rules in place by April 1, Nicole Comeaux, Human Services Department Medicaid director, told NM Political Report.

The federal American Rescue Plan Act (ARPA) made changes in how the state can ask for Medicaid dollars to encourage states to expand Medicaid for pregnant women.

Comeaux said this change enabled HSD to start the process of expanding Medicaid coverage to all expecting individuals, including those who miscarry.

She said it could impact up to 17,000 individuals in the state.

“This is critically important for the country, but even more so for New Mexico,” Comeaux said.

Nearly a third of all maternal deaths occur between one week and one-year postpartum, Comeaux said.

“Postpartum care is critical to monitoring health after pregnancy as well as to addressing other health care needs. However, under current law, coverage for those enrolled in Medicaid by virtue of their pregnancy ends after 60 days postpartum and many individuals are not otherwise eligible for Medicaid,” Comeaux said.

In New Mexico, maternal mortality rates are higher than the national rate. Comeaux said that according to 2018 data, which is the most recent available, maternal mortality rates in the country are at 17.4 deaths per 100,000 births but in New Mexico, the mortality rate is 21.5 deaths per 100,000 births, she said.

Comeaux said that given that the majority of New Mexico’s population are Hispanic/Latino and Native American, the higher incidence of maternal mortality is an equity issue.

African-American, Hispanic and Indigenous women have higher risks associated with pregnancy and higher morbidity and mortality than Caucasian women, Comeaux said.

“We have a population that is at a much higher risk with ongoing health disparities and eliminating access to coverage [after two months postpartum] at such a critical time perpetuates those disparities,” she said. “It’s critical for New Mexico for access issues folks face across the board.”

The short postpartum period of 60 days, which is the current Medicaid coverage, disrupts coverage and access to care. Among women whose births were paid for by Medicaid, nearly one in four report being uninsured postpartum, she said.

“Inadequate postpartum care may contribute to persistent racial and ethnic disparities in maternal and infant health outcomes. Black, Hispanic and Indigenous women have higher risks of maternal morbidity and mortality,” Comeaux said.

She said the governor has made the $14.4 million to implement the expansion a part of the governor’s FY23 budget request. The request will be annual. If approved by the Legislature, the expansion will be funded through a combination of both federal and state dollars.

The change in federal rules that will allow the expansion will continue for five years. At that point, the federal government will decide to extend the rule-making change or terminate it, Comeaux said.

New Mexico has the highest percentage of people in poverty in the country at 19.2 percent, Comeaux said. The majority of all babies born in the state – 72 percent – are born covered by Medicaid. Comeaux said New Mexico ranks highest in the country for babies born under Medicaid coverage.

Medicaid currently covers 961,000 individuals in the state, which amounts to 46 percent of the population.

“Postpartum care is just so critical to monitor health after pregnancy,” Comeaux said.