Governor Inslee recently signed a bill that allows for one-year of postpartum Medicaid coverage for Washingtonians with an income at or below 193% of the federal poverty level. It makes permanent a provision put in place during the COVID 19 pandemic. This bill was based on recommendations from the WA State Maternal Mortality Review Board which included two of our faculty, Amritha Bhat, MD, MPH, and Ian Bennett, MD, PhD.

Maternal mortality rates in the United States continue to be higher than most other high income countries. Almost half of all the births in the Washington State (and 66% of births to Black women) are covered by Medicaid. Traditionally, Medicaid coverage in the perinatal period ends at 60 days postpartum, leading to unsafe gaps in healthcare at an important time in the lives of new parents and their infants. The hormonal, physical and emotional changes that occur following delivery, and the adaptation to new roles and family structures can last much longer 60 days and can require more than one healthcare encounter.

As a result of this new bill, new mothers will no longer abruptly lose Medicaid coverage in the vulnerable postpartum period. Stable and uninterrupted care will lead to better health and mental health outcomes for both the birthing parent and the child. This policy change is an important opportunity to begin to address longstanding inequities in postpartum healthcare. Black people, people of color and people with low income are more likely to lose healthcare coverage in the postpartum period and experience discontinuity of care. Medicaid expansion can support comprehensive postpartum mental health, substance use and physical health care and can potentially reduce disparities in maternal mortality.