Broad Health Care Coalition Supports Medicaid Extension for Postpartum Care

Joint Press Release on Expanding Postpartum Coverage

JUNE 10, 2021 -- RALEIGH – The broad coalition of health care associations shown above, representing thousands of physicians and PAs throughout North Carolina, have joined together to support proposed legislation (SB530 – Medicaid for Twelve Months Postpartum) extending Medicaid coverage for new mothers to a full year after the birth of their child. Research has shown that insurance during this critical postpartum period is associated with better outcomes for both mother and child.

“The NCMS has long supported efforts to reduce the rates of maternal mortality in North Carolina as well as policies that seek to improve maternal and infant health,” said NCMS President Philip Brown, Jr., MD. “Health challenges from pregnancy often extend up to a year postpartum, and a lack of insurance coverage is connected with worse outcomes for mothers and infants. The bill currently under consideration addresses this issue and is especially vital for women of color and immigrant women who disproportionately suffer from poor health and high maternal mortality rates.”

The state’s current Medicaid coverage for new mothers leaves roughly half of new mothers uninsured 60 days after delivery of their baby, according to the North Carolina Institute of Medicine’s (NCIOM) 2020 Perinatal Systems of Care Report.

“There is a growing awareness that pregnant individuals face increased health risks not only during pregnancy, labor and delivery, but also for months afterward,” said NC Obstetrical and Gynecological Society President Velma Taormina, MD. “Nearly a third of postpartum-related deaths occur one week to a year after the end of a pregnancy. We believe that allowing individuals to maintain Medicaid coverage for a longer period during this vulnerable time will not only improve access to and continuity of care, but will ultimately improve their health outcomes."

The NCIOM report found that a lack in insurance coverage postpartum is associated with
• Early cessation of breastfeeding;
• Shorter periods of time between pregnancies;
• Untreated mental health issues, including depression and anxiety; and
• Higher rates of preterm birth, and infant mortality.

These findings impact the health of the mother as well as their infants and the overall physical and mental well-being of their family.

“Research shows babies are more likely to thrive when their mothers get the care they need. And I see this played out every week in my practice,” said Theresa Flynn, MD, MPH, co-chair of the Policy Committee of the NC Pediatric Society. “Extending maternal benefits is an important strategy for improving health outcomes for babies as well as mothers.”

North Carolina’s maternal mortality rate (27.6 deaths per 100,000 births) between 2013-2017 was just under the national average (29.6 deaths per 100,000 births).

“It is clear that extending access to health care coverage for new mothers will have a strong positive impact,” said President of the NC Academy of Family Physicians Jessica L. Triche, MD, FAAFP. “For every mother who dies from a pregnancy-related cause, NCIOM estimates another 20 or 30 mothers suffer from acute or chronic morbidity. Access to care beyond 60 days will clearly improve both maternal mortality and morbidity.”

The data is indisputable.

“According to the federal Centers for Disease Control and Prevention, nearly 23 percent of pregnancy-related deaths after the day of delivery occur in the period between six weeks after delivery and the end of the first year,” said Lacy C. Hobgood, MD, FACP, FAAP, Governor for the NC Chapter, American College of Physicians. “Yet for most pregnant women who receive health coverage through Medicaid, those benefits end 60 days after delivery, leaving them without health insurance during a precarious postpartum period. We need to value women’s health during the period of childbirth beyond pregnancy.”

Medicaid beneficiaries are often most in need of this care.

“The evidence strongly supports extending the definition of postpartum through the first 12 months after delivery to mitigate maternal and infant morbidity and mortality, particularly among some of our most vulnerable patients who need Medicaid coverage to allow access to primary care services,” said President of the NC Academy of Physician Assistants Elyse J. Watkins, DHSc, PA-C.

Physicians and PAs across the state strongly urge the public to reach out to their elected officials to encourage them to adopt this common-sense proposal.

“The NC Osteopathic Medical Association (NCOMA) supports this legislation,” said NCOMA President Michael Murphy, D.O. FACOFP, dist. “We know that postpartum care is an on-going process that involves multiple visits and follow-up care in the year following delivery. Providing Medicaid coverage for mothers for up to one year is essential for prevention, early detection and treatment of conditions that place women at higher risk for pregnancy-related mental and physical complications.”

About the North Carolina Medical Society
The North Carolina Medical Society is the oldest professional member organization in North Carolina, representing physicians and physician assistants who practice in the state. Founded in 1849, the Society seeks to provide leadership in medicine by uniting, serving and representing physicians and their health care teams to enhance the health of North Carolinians.

About the NC Academy of Family Physicians
The North Carolina Academy of Family Physicians, Inc. (NCAFP) is a non-profit professional association headquartered in Raleigh representing over 4,200 family physicians, family medicine residents and medical students across North Carolina. The NCAFP is a constituent chapter of the American Academy of Family Physicians, based in Leawood, Kansas.

About the NC Pediatric Society
Founded in 1931, the North Carolina Pediatric Society (NCPeds) is the state affiliate Chapter of the American Academy of Pediatrics with more than 2,000 pediatrician and pediatric health professional members. Its mission is to empower pediatricians and its partners to foster the physical, social, and emotional well-being of infants, children, adolescents and young adults.

About the NC Obstetrical and Gynecological Association

The North Carolina Obstetrical & Gynecological Society is the voice of Ob/Gyn physicians in North Carolina. Through education, advocacy, communications and professional relations, we represent your professional interests and promote excellence in patient care.

About the NC Academy of Physician Assistants
The North Carolina Academy of Physician Assistants is the voice of PAs in North Carolina and provides innovative solutions to empower its members to enhance their careers. Through our collective efforts, PAs are recognized as vital resource for the treatment of patients in North Carolina. NCAPA membership includes full- and part-time practicing PAs, retired PAs, PA educators, PA students, as well as NPs and others interested in supporting the PA profession.

About the NC Osteopathic Medical Association
NCOMA is the state’s oldest Osteopathic Medical Association established to promote, advocate, maintain and support the philosophy of Osteopathic Medicine for the benefit of the profession and the people of North Carolina.

About the NC Chapter of the American College of Physicians
The NC Chapter of the American College of Physicians represents North Carolina’s diverse community of internal medicine specialists and subspecialists united by a commitment to excellence.