Mississippi can spend about $7 million a year to keep mothers and newborns healthier, or continue to spend tens of millions more dealing with the fallout of having the worst infant and maternal mortality and morbidity in the country, health experts told lawmakers Thursday.
“This reminds me of that Midas commercial: Pay me now, or pay me later,” said Sen. Kevin Blackwell, R-Southaven, chairman of the Senate Medicaid Committee. “The cost later is obviously significantly more. The relatively minimal amount to provide this care compared to the cost later – it’s a no brainer in my mind.”
Blackwell’s committee on Thursday heard testimony from numerous health experts on benefits of increasing the length of postpartum Medicaid health coverage for mothers from 60 days to a year – as most states have done or are considering. Postpartum coverage has been extended for mothers in all states during the federal pandemic health emergency but will end when the national emergency is ended, which is expected to happen soon.
Lt. Gov. Delbert Hosemann has vowed the Senate in the 2023 legislative session will again push for extending postpartum coverage. Early this year, Speaker Philip Gunn and the House leadership blocked three Senate attempts to extend the coverage. Gov. Tate Reeves has been noncommittal on the issue. But all three leaders have noted a need for policies to help new and expecting mothers and newborns after a ban on abortions is expected to add at least 5,000 more births in Mississippi each year.
In Mississippi with high rates of poverty and uninsured people, about 65% of babies are born to mothers on Medicaid. Because of lag times in being approved for coverage and the 60-day cutoff, mothers often do not receive the prenatal and postpartum care they need, care that could prevent many major problems.
Dr. Anita Henderson, a pediatrician and president of the Mississippi Chapter of the American Academy of Pediatrics, provided some somber statistics and costs to lawmakers Thursday.
Mississippi’s pregnancy-related maternal mortality ratio is 33.2 deaths per 100,000 live births, nearly double the national average of 17.3 deaths. Mississippi has the highest infant mortality rate, preterm birth rate and low birthweight rate in the U.S. One-in-seven babies born here are preterm. These numbers are dated by a few years, and rates have gotten worse, lawmakers and experts said Thursday.
Henderson said the hospital cost for a healthy baby born full term runs about $5,000 to $6,000. But for extremely premature babies, that cost averages $600,000 and can easily top $1 million – costs frequently borne by state Medicaid.
“If we can prevent just a few of those premature births, we would be able to pay for this, and also help 65% of moms in Mississippi,” Henderson said.
State Health Officer Dr. Daniel Edney said he believes extending the coverage would not only pay for itself but be “budget positive” for the state, with savings from healthier mothers and babies with preventive and follow-up care, and federal Medicaid covering most of the cost.
“The rest of the states have adopted 12 month postpartum or Medicaid expansion,” Edney said. “We are one of two states in the nation that has adopted neither. We are kind of isolated in our current policy. What I would beg us to consider is the fact it makes much more economic sense to let Medicaid pay for this rather than the state having to pay for it – either state agencies such as the health department paying, or hospitals paying for it with uncompensated care.”
But Edney advised lawmakers to, “Please divorce the Medicaid expansion debate from the postpartum benefits debate. We can have the Medicaid expansion debate at another time.”
Expanding Medicaid to cover the working poor in Mississippi per the federal Affordable Care Act has been the source of a decade of partisan debate in Mississippi, with GOP leaders blocking it. Blackwell opposes Medicaid expansion, but along with other Senate Republicans said extending postpartum coverage to mothers already on Medicaid for their pregnancies is not the same as the broader expansion.
Wil Ervin, deputy administrator for health policy for Mississippi Medicaid, on Thursday told lawmakers his agency is not making a recommendation to lawmakers for or against extending postpartum coverage.
“But if you do, we would ask that you do so quickly and decisively, and give the division enough time to successfully implement the changes,” Ervin said.
Sen. David Blount, D-Jackson, in questions to several presenters Thursday indicated Gov. Reeves could promptly extend the coverage without Legislative action next year.
“Isn’t it true the executive branch today could make that happen without us waiting for the other chamber? This afternoon, he could sign a piece of paper and solve these problems. But if that doesn’t happen, I think you’ll see a continued commitment from the Senate.”