Medicaid boost would give a year of postpartum care to Florida moms

Legislation announced by House Speaker Chris Sprowls would extend the benefit beyond the current limit of 60 days.
Florida House Speaker Chris Sprowls, R-Palm Harbor, speaks on the opening day of the 2021 legislative session earlier this month. On Tuesday, he announced legislation to expand postpartum Medicaid coverage for new mothers in Florida.
Florida House Speaker Chris Sprowls, R-Palm Harbor, speaks on the opening day of the 2021 legislative session earlier this month. On Tuesday, he announced legislation to expand postpartum Medicaid coverage for new mothers in Florida. [ IVY CEBALLO | Times ]
Published March 23, 2021|Updated March 23, 2021

TALLAHASSEE — New Florida mothers covered under Medicaid would receive a year of health care benefits after delivery instead of the current allowance of 60 days, under legislation announced Tuesday by House Speaker Chris Sprowls.

“Today, the Florida House is making a meaningful commitment to address the disparities in health outcomes for our children and for their moms,” said Sprowls, a Palm Harbor Republican. “We believe that providing the access to postnatal coverage for up to one year after the birth can significantly boost health outcomes for moms and their babies and we know that healthy moms are better positioned to raise healthy and thriving children.”

The postnatal period can be an especially vulnerable time, exposing mothers to a number of potential health complications. Of the approximately 700 deaths across the United States resulting from maternal health-related causes every year, one-third occur during the postpartum period, according to Centers for Disease Control and Prevention data.

In Florida, the rate of maternal deaths has improved over the years, according to experts. Still, racial disparities persist. Of the 36 women who died in Florida due to pregnancy-related complications in 2018, about half were Black, according to Florida’s Pregnancy-Associated Mortality Review data.

“This problem impacts minority communities disproportionately,” state Rep. Kamia Brown, D-Ocoee, said during a news conference, where she appeared with Sprowls. Brown is sponsoring a similar bill, HB-645, along with several other proposals aimed at addressing racial disparities in maternal health care.

“This extension is critical for mothers, going leaps and bounds beyond what is offered in the past,” she said.

Since the 1970s, mothers covered by Medicaid have had access to two months of postpartum care, according to Brown, a Black woman who gave birth to her first child last year. It “really opened my eyes even more,” she said.

She said she lost her godsister, who went into her pregnancy in good health, to postpartum hemorrhaging.

In Florida, “we’ve done more work on the infant mortality side,” Brown said in a recent interview. This bill places a greater emphasis on the health of mothers, she said.

Such bipartisan buy-in has been rare for a Legislature that often divides sharply along party lines.

“We are not philosophically divided,” said Rep. Nick Duran, D-Miami, the ranking member of the Health & Human Services Committee. “We are seeing some very productive conversation. ... I’ve been here since 2016 and we’ve never really had that.”

In Tampa Bay, groups like federal Healthy Start programs have been working for years to reduce racial disparities in maternal mortality. While Black babies once were almost five times more likely to die in childbirth than white babies, the disparity is down to three times more likely.

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“That’s still insufficient,” said Rep. Fentrice Driskell, D-Tampa, who called Sprowls’ leadership on the issue “very meaningful.”

The 10-month extension would increase access to postpartum care for new mothers, including mental health assessments and follow-up physician visits. Across the state, 97,600 women would be eligible for care under the extension, according to the Agency for Health Care Administration.

Under the 60-day policy, “a lot of women fall off the coverage cliff at that moment in time,” said Alison Yager, deputy executive director of the Florida Health Justice Project. “We need to think about moms being healthy throughout their whole life, not just during pregnancy.”

With the extension, “we’re putting people on better footing to go into a subsequent pregnancy,” Yager said. And that allows women to address concerns like postpartum depression, which doesn’t end two months after delivery.

While the extension represents a step forward, some advocates say it should be only the beginning of a multifaceted approach to addressing maternal mortality and the disparities that persist.

“It’s a start” said Jennie Joseph, a midwife and maternal health advocate in Orlando. But “you’ve got other bureaucratic hurdles,” including a shortage of providers willing and able to take on Medicaid patients for an additional 10 months.

Currently, as a midwife, “if I’m lucky, I can get $34 for a postpartum visit,” under the Medicaid reimbursement system, Joseph said. “We need the workforce development piece because we need boots on the ground.”

The extension would include only those already covered under the postpartum Medicaid plan. Of the $240 million investment, about $92 million would be state funds.

The Republican-led state Legislature continues to push back on expansion of Medicaid as whole under the Affordable Care Act, which would insure thousands more Floridians, including children.

A hearing for the bill will be held this week in the Health Care Appropriations Subcommittee. The measure is all but certain to pass the House, given its backing by leadership.

Its fate in the Legislature’s other chamber, the Senate, is less clear.

“We’re excited to work with them on this issue,” said Sprowls. “We’ve had great partners in the Senate, great partners with the executive office of the governor. So, we look forward to engaging with them on this.”

The Foundation for a Healthy St. Petersburg provides partial funding for Times stories on equity. It does not select story topics and is not involved in the reporting or editing.