MEDICAID ISSUE BRIEF: Postpartum Medicaid Implementation

April 2024

Medicaid Brief Graphic with supplementary information on maternal mortality with key data points as follows: 31% of maternal deaths occur during pregnancy, 17% around the time of delivery, 52% durring postpartum (up to one year following birth)Together with our partners at Pritzker Children’s Initiative and Merck for Mothers, CHAP is pleased to share a new issue brief: Postpartum Medicaid Implementation.

Detailing the current state of postpartum Medicaid extensions—to date, 45 states have expanded coverage, the brief focuses on recommendations for how funders can support the success and implementation of the 12-month postpartum Medicaid benefit.

Until two years ago, Medicaid coverage for women who qualified during pregnancy automatically ended 60 days after giving birth. However, with the passing of the American Rescue Plan Act of 2021, states were given the option to extend coverage to 12 months postpartum, marking a significant shift in policy.

Data released by the CDC in 2022 indicates that over half of pregnancy-related deaths from 2017-2019 occurred during the postpartum period. While the evidence about what is leading to mortality and morbidity is clear, there is little shared understanding about what a comprehensive model of care looks like during the 12 months following birth and no existing structural mechanisms for addressing systemic, provider and individual level barriers. It is time to reimagine postpartum care.

Developed by the team at Afton Bloom, the goal of this brief is to mobilize fellow funders to act now to support Medicaid extension and implementation efforts across states. Together, we can drive greater impact and improve care and outcomes for all.

Key Recommendations include:

  1. Fund the development of a widely accepted standard of postpartum care. Fund the facilitation of state and national efforts to determine a comprehensive and collaborative model of 12-month postpartum care that addresses the clinical setting and system levels.
  2. Build the evidence base for meeting the standard of care. Fund research and implementation science that pilots and assesses postpartum care and funding models.
  3. Support programs and organizations to provide comprehensive postpartum care. Support workforce development initiatives to increase the compensation of culturally congruent birth workers and fund the development and delivery of trauma-informed postpartum education for birth workers and clinical providers.
  4. Build awareness and narrative change. Support efforts to increase and/or improve reproductive health education and campaigns to provide information about coverage and benefits that reduces stigma around Medicaid.


Download the Brief

We hope this document will serve as a useful and empowering resource and thank you for your interest in supporting efforts to address key gaps in the postpartum care infrastructure.