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The Energy and Commerce Committee in the House of Representatives took a major step forward in addressing our nation’s maternal health crisis by passing two landmark bipartisan bills last week: the Maternal Health Quality Improvement Act and the Helping Medicaid Offer Maternity Services (MOMS) Act.
Racial inequities in maternal health have reached crisis proportions, with mortality for Black and Indigenous women nearly four times as high as for white women. Across the country, advocates have demanded action on maternal health. National advocates such as Black Mamas Matter Alliance, the National Birth Equity Collaborative and the Black Women’s Health Imperative, as well as state-based groups such as the Afiya Center in Dallas and EverThrive Illinois, are actively working to improve maternity care for women of color and have long called on legislators to take this up as a priority.
The Maternal Health Quality Improvement Act and the Helping MOMS Act are the first significant legislative steps to ensure that all pregnant people have access to high-quality health care, free of bias and discrimination, throughout the prenatal and postpartum period. The Maternal Health Quality Improvement Act would create resources and opportunities to improve the quality of care provided during pregnancy and specifically tackle the disgraceful levels of bias and disrespect that women of color face in the delivery room, often leading to worse outcomes. Specifically, the bill would authorize grants to support innovation in maternal health programming, enable medical and nursing schools to implement programs aimed at preventing discrimination in maternity care, direct HHS to study and make recommendations for reducing provider discrimination and authorize funding for perinatal quality collaboratives. The bill was passed by the Energy and Commerce Committee with an amendment that would require the Centers for Disease Control and Protection to improve data collection on race, ethnicity and other demographic information related to maternal mortality and morbidity.
The Helping MOMS Act is a critical step towards ensuring that new mothers have access to health care when they need it most. The majority of maternal deaths happen not during delivery, but rather during the vulnerable postpartum period. Nearly one quarter of deaths happen more than six weeks postpartum, a period when new mothers can face a range of medical challenges, such as complications from childbirth, chronic conditions, or postpartum depression all while caring for a newborn. Despite these risks, pregnancy-related Medicaid currently only covers women for eight weeks after delivery of a child. This coverage cutoff exposes new mothers to a health insurance cliff and, particularly in states without Medicaid expansion, can leave them without access to medical services that are essential for their well-being, as well as the health of their infants. The Helping MOMS Act would enable states to use a state plan amendment to extend Medicaid coverage for new moms through one year postpartum, allowing them to access critical health services. The bill incentivizes this extension by providing a one-year, 5 percentage point Federal Medical Assistance Percentage (FMAP) enhancement to states who choose the option.
This legislation also paves the way for more targeted and robust policy opportunities, as it applies to postpartum Medicaid coverage specifically. In particular, legislation that fully accomplishes the goal of postpartum coverage would mandate that all states implement 12 month postpartum Medicaid coverage and provide a higher FMAP of 90 percent in order to ensure success. We applaud this initial and important first step in improving maternal health and look forward to further legislation guided by advocate voices.
The unanimous passage of these two bills would not have been possible without the tireless advocacy efforts of groups that center the voices of women and families most affected by maternal mortality and morbidity. Among these efforts, our partners at The Black Women’s Health Imperative worked with Rep. Lauren Underwood on the legislation and both Black Mamas Matter and March for Moms organized sign-on letters to express support.
Reacting to the bill, Community Catalyst Board member Dr. Joia Crear-Perry stated: "As an OB/Gyn and founder of the National Birth Equity Collaborative who is also a board member of the Black Mamas Matter Alliance, it gives me great hope to see efforts to provide coverage to birthing people after the baby is born. Since we know the majority of maternal deaths occur in this period, it is critical that we show we value the lives of those who have given birth and providing them with coverage is a step towards that end."
As these critical bills make their way to the house floor, state based advocates around the country can support the women-of-color-led groups who are pushing the maternal health movement forward by voicing public support for these two bills. Rising rates of maternal mortality and morbidity, particularly for women of color, show the urgent need for these measures. Join us in communicating this urgency to the house by urging members to pass these bills.
Tess Solomon is a consultant with the Women's Health Program at Community Catalyst.