Postpartum coverage is critical in Mississippi, the poorest state in the nation with high rates of infant and maternal mortality.

Mississippi women who have given birth will likely continue to receive Medicaid health care coverage until at least the end of 2021 even after legislation recently died that would have extended the coverage.

During the 2021 Mississippi legislative session, Senate leadership attempted to place in state law a requirement that postpartum coverage would be expanded from 60 days to 12 months for mostly low-income women. That coverage is particularly important in Mississippi, the poorest state in the nation with high rates of infant and maternal mortality.

The Senate tried to include the postpartum coverage expansion in the Medicaid bill passed during the 2021 session designed to make various technical amendments to the complex federal-state health care program. The House rejected that proposal.

But Matt Westerfield, a spokesperson for Mississippi’s Division of Medicaid, told Mississippi Today that federal emergency orders “will likely” keep the coverage in place through 2021.

“Because of the federal Families First Coronavirus Response Act enacted in March 2020, Medicaid recipients, including pregnant women, are receiving continuous Medicaid coverage for the duration of the federal public health emergency,” Westerfield said. “The Biden administration has informed states that the federal COVID-19 public health emergency will likely remain in place for the entirety of 2021.”

When the legislation failed this year, House leaders pointed out that the coverage would remain in effect because of the federal health care emergency status. House Speaker Philip Gunn contended that adding the postpartum expansion to the Medicaid technical amendments bill was not allowed under legislative rules.

“The code section that involved that was not in the bill and it was subject to a point of order,” Gunn said, adding, “there was an individual who had informed us he was going to raise the point of order.”

When asked if expanding the postpartum coverage should be considered in the 2022 session, Gunn said, “I don’t know if Medicaid is the answer to that, but certainly we are concerned… We will probably be looking at ways to address that. Expansion may or may not be a way to address that. It is just something we need to look at.”

Mississippi has the highest infant morality rate in the nation with 9.07 deaths per 1,000 births, according to the U.S. Centers for Disease Control and Prevention. Mississippi also has the 19th-highest maternal mortality rate at 20.8 deaths per 100,000 births, according to a study released by USA Today in 2019.

Lt. Gov. Delbert Hosemann has said that the Senate will be studying issues surrounding health care access and outcomes in the coming months.

Twelve states, including Mississippi, have not expanded Medicaid as is allowed under federal law to provide health care coverage for primarily the working poor. With Medicaid expansion, presumably poor women who give birth would have continuous coverage as long as they are in lower income levels. The Medicaid expansion would not entitle people who qualify to any additional funds, but instead would make them eligible for health care coverage.

There have been proposals that would mandate any Medicaid expansion in Mississippi to include a minimal co-pay for health care for people covered by the expansion.

While pregnant women in Mississippi are now receiving the continuous Medicaid coverage, the state is receiving extra funds from the federal government to pay for it. Under the March 2020 Families First Coronavirus Response Act, the federal government is providing a matching rate of near 85% for Mississippi Medicaid recipients. In other words, for each dollar of health care provided through Medicaid, the federal government is paying almost 85 cents and the state is paying the remainder.

In addition, under the more recent American Rescue Plan, the federal government would provide incentives of about $600 million for Mississippi over a two years to expand Medicaid to cover primarily the working poor. Thus far, state leaders, including Gunn and Gov Tate Reeves, have rejected the incentive package. Hosemann has indicated that all avenues of improving health care access, including for postpartum coverage, will be studied this summer.

In the meantime, the Mississippi Hospital Association voted last week to back a ballot initiative that would ask voters to approve expanding Medicaid in the state. Supporters of that effort believe they can start gathering signatures by May 1, 2021, and that the question could be placed on a statewide ballot by 2022.

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Bobby Harrison, Mississippi Today’s senior capitol reporter, covers politics, government and the Mississippi State Legislature. He also writes a weekly news analysis which is co-published in newspapers statewide. A native of Laurel, Bobby joined our team June 2018 after working for the North Mississippi Daily Journal in Tupelo since 1984. He is president of the Mississippi Capitol Press Corps Association and works with the Mississippi State University Stennis Institute to organize press luncheons. Bobby has a bachelor's in American Studies from the University of Southern Mississippi and has received multiple awards from the Mississippi Press Association, including the Bill Minor Best Investigative/In-depth Reporting and Best Commentary Column.