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Extended Medicaid coverage for new moms is still alive in the state Legislature, but barely.
Sen. Kevin Blackwell, R-Southaven, on Tuesday invoked a legislative maneuver that could revive his bill to extend Medicaid coverage from 60 days to a year postpartum.
Speaker Philip Gunn, R-Clinton, had effectively killed the bill earlier this month, despite pleas from physicians and medical experts who say the extended coverage would reduce maternal mortality and improve outcomes for babies and families in a state with the country’s highest infant mortality rate.
Blackwell’s resolution to suspend the rules Tuesday evening passed the Senate with little opposition. Lt. Gov. Delbert Hosemann, who presides over the Senate, had pledged to “appeal to (Gunn’s) Christian values” to try to persuade him to support the postpartum Medicaid extension.
Now, the resolution goes to the House. If the House passes the resolution, the Senate could again take up Blackwell’s bill and eventually send it back to the House.
Gunn cited his opposition to Medicaid expansion when asked why he did not support the bill. But Blackwell’s legislation would not expand Medicaid eligibility; it would extend coverage for people who already qualify.
Blackwell told Mississippi Today on Tuesday night that he’s not optimistic about the legislation’s prospects in the House.
“I hope they take it up, but I believe they’ll just let it die,” he said. “The speaker calls it expansion when it is not.”
Emily Simmons, Gunn’s communications director, said Tuesday night that she could not comment because her office had not had the chance to review Blackwell’s resolution.
“I think there were different views on whether this expands Medicaid,” Gunn told Mississippi Today when the bill died on March 9. “I have been very clear that I oppose Medicaid expansion, and that I believe we should be working to get people off Medicaid as opposed to adding more people to it.”
Several other states that have not expanded Medicaid eligibility under the Affordable Care Act have extended postpartum coverage to at least six months, including Georgia, Tennessee and Florida.
The apparent death of the postpartum Medicaid extension earlier in the session sparked an outcry from doctors and advocates for women’s and infants’ health in Mississippi.
“I feel as if they are playing politics with women’s lives,” Cassandra Welchlin, co-convener and state lead of Mississippi Black Women’s Roundtable, told Mississippi Today.
A 2019 health department report on maternal mortality in the state reviewed every pregnancy-related death in Mississippi from 2013 to 2016. The report found that nearly 40% of all such deaths occurred more than six weeks postpartum.
Heart conditions and hypertensive disorders were the two most common causes of death, and Black women in Mississippi are three times likelier than white women to die of pregnancy-related complications.
During the public health emergency due to COVID-19, the federal government has prevented states from kicking people off Medicaid during the pandemic. That has allowed Mississippi moms up to this point to retain coverage after they give birth. But when the emergency declaration expires, likely sometime this year, they will once again lose coverage at 60 days postpartum.
On the Senate floor Tuesday night, Sen. Angela Burks Hill, R-Picayune, asked Blackwell whether he was aware that, since the passage of Obamacare, women could obtain Medicaid coverage without “a doctor’s visit or any test” to demonstrate that they are pregnant.
According to the Mississippi Division of Medicaid, “self-attestation” of pregnancy is sufficient for someone to qualify for coverage if they also meet income requirements. But Medicaid can require verification if information like claims data conflicts with that self-attestation.
“What we could be doing is letting a lot of people get on Medicaid who aren’t pregnant,” Hill said.
“Are you aware this is postpartum? And that occurs after birth?” Blackwell responded.
“Everybody’s about pro-life, and if you’re pro-life, you’d be for this bill,” he continued.
Hill said that she is pro-life and that her church has a relationship with a crisis pregnancy center, which counsel pregnant women not to get abortions.
“Don’t tell me I’m not pro-life because I don’t support this bill,” she said.
Hill and at least five other senators voted against the rules suspension.