The Missouri Senate has given initial approval to expanding how long someone would have access to Medicaid coverage after giving birth.
However, the expansion will only occur after around 5,000 people are removed from the state’s Medicaid program.
Senators gave first-round approval to legislation on Tuesday that expands coverage for one full year after giving birth. It must go through one more vote before moving on to the House.
Bill sponsor Sen. Elaine Gannon, R-De Soto, said it would help one of the state’s most vulnerable populations.
“Extending coverage to these women is so important because some of the conditions do not always present themselves in the first 60 days postpartum. They may take several months to appear,” Gannon said.
Under current Missouri law, mothers earning a low income who receive care through MO HealthNet or the Show-Me Healthy Babies program are eligible throughout their pregnancy and for 60 days after delivery.
This expanded coverage would be available if federal authorization for it is in effect. Currently, the American Rescue Plan Act is allowing for such coverage for five years.
Sen. Tracy McCreery, D-Olivette, who is a co-sponsor of the legislation, said the bill would help about 4,600 women who have a specific need regarding coverage.
“These are women that don't have coverage, because they're not low income enough to get to go into other pots of Medicaid eligibility,” McCreery said. “But yet, they don't make enough to be able to go to the marketplace and buy their own insurance.”
However, also included in the bill is a stipulation that it cannot move forward until the number of ineligible Medicaid participants removed from the program exceeds the number of people projected to enroll in the new program by at least 100.
Because the maternal health program is predicted to aid around 4,600 people, about 4,700 people would need to be removed from Medicaid for the plan to go into effect.
Missouri will resume the process of redetermining who still qualifies for Medicaid coverage on April 1, after a three-year pause. In addition to restarting the process, $16.8 million is being proposed for the upcoming budget to go toward that redetermination process.
The Missouri Independent has reported that around 200,000 current Medicaid enrollees are predicted to lose coverage over the course of the year, meaning that threshold would be easily met.
Sen. Bill Eigel, R-Weldon Spring, said this new language reformed Medicaid as opposed to just expanding it.
“I think that by requiring stronger language, specific targets that have to be met before we expand any benefits, we've set a limit to say, ‘Hey, this program needs to go through a reform process,’” Eigel said.
Additionally, the legislation enacts a ban on the state providing payments through Medicaid to patients who don’t reside in Missouri.
Another part of the bill is a stipulation that no one who receives a service that is against state law would be eligible for the Medicaid benefits.
McCreery said on the Senate floor she assumed that section addressed abortion.
An average of 61 Missourians each year died while pregnant or within one year of giving birth, according to a report published in 2022 by the Missouri Department of Health and Senior Services. The report studied maternal deaths from 2017-19.
The rate of mothers on Medicaid dying within one year of pregnancy was eight times higher than those with private health insurance.
Efforts to curb the state’s maternal mortality rate have the support of Gov. Mike Parson.
“DHSS estimates that 75% of maternal deaths are preventable with at least one meaningful change to treatment, whether directly to the patient or through the provider, community or healthcare services,” Parson said in his State of the State address last month. “We refuse to accept this tragic Missouri statistic. We must do better.”
Included in his recommended budget for the upcoming fiscal year is $4.4 million toward addressing maternal mortality.
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