CMS expands postpartum coverage under Medicaid, CHIP

The Biden-Harris administration is expanding Medicaid and Children's Health Insurance Program coverage to allow state plans to offer postpartum care for 12 months starting April 1.

The move affects up to 720,000 people nationwide and aims to address the crisis of pregnancy-related deaths and maternal morbidity, according to an April 1 press release.

Louisiana is the first state to offer the new program to 14,000 pregnant and postpartum individuals. CMS is also working to enact the program in nine other states.

In 2021, Illinois, New Jersey, and Virginia were the first states to use Medicaid demonstration authority to provide 12 months of continuous postpartum coverage for all Medicaid and CHIP members. Other states have also said they are working to extend Medicaid coverage to 12 months after pregnancy. To receive federal funds and ensure consistency with federal standards, states must go through a formal process run by CMS.

States choosing to extend postpartum coverage must elect this option in both Medicaid and their separate CHIP programs and submit required state plan amendments to CMS. The new American Rescue Plan state plan option is currently limited to a five-year period that ends on March 31, 2027.

States that adopt the new postpartum coverage must provide coverage to all eligible individuals who were enrolled in Medicaid or CHIP while they were pregnant. Extended coverage will last from the day the pregnancy ends through the end of the month in which their 12 month postpartum period ends. The coverage option extends to current members who are enrolled in Medicaid or CHIP while pregnant but are no longer pregnant when the state implements the ARP option if the individual is within their 12-month postpartum period when their state implements the option. Coverage also applies to individuals who were pregnant at some point during the three months prior to applying for Medicaid if they met the eligibility requirements at that time.

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