By Thomas Westover, Julie Blumenfeld and Patricia Suplee
Originally published to NJ.com on November 11, 2021
New Jersey became the first state in the region, and only the second in the country, last month to ensure that residents who give birth have access to health care for a full year following their babies’ delivery.
As obstetricians, midwives and nurses who live in New Jersey, we care for pregnant and postpartum patients every day. That’s why we are thrilled that the federal government recently approved Gov. Phil Murphy’s timely request to extend the time frame that Medicaid covers postpartum care for recently delivered patients from approximately 60 days after birth to one full year after birth.
Currently, approximately 30,000 pregnant patients receive Medicaid coverage during pregnancy in New Jersey each year. In the past, nearly a third of this population would have lost coverage two months after delivery because they would no longer meet the income requirements for standard Medicaid eligibility. This federal waiver now allows the state to extend potentially lifesaving coverage for almost 9,000 patients.
Many more new parents will now have access to treatment and support through one of the most challenging transitions of their lives — a period in which hundreds of mothers nationally are lost to preventable deaths.
As our First Lady Tammy Murphy said recently, this is “a commonsense, necessary, and moral imperative for any state that values healthy families.” Extending pregnancy-based Medicaid coverage will improve maternal and infant health and reduce preventable deaths. It should, in addition, help narrow the racial disparities that make having a baby more dangerous for people of color than for white people.
Nationally, Medicaid covers pregnancy-related care and childbirth for approximately 40% of patients giving birth; the rate is similar in New Jersey. After delivery, parents are vulnerable to physical and mental health challenges that can threaten their lives — chronic illnesses, such as hypertension, asthma, or diabetes, as well as behavioral health conditions, like postpartum depression and substance use disorder.
The Centers for Disease Control and Prevention (CDC) found that one in three pregnancy-related maternal deaths occur between a week and a year after delivery (and this statistic excludes suicide and overdose deaths, which are leading causes of postpartum mortality).
Many of these fatalities are preventable. Gaps in health insurance are part of the reason why the United States is the only industrialized nation experiencing a rising rate of maternal mortality. This lack of coverage and care also contributes to persistent racial inequities in health outcomes. In New Jersey, Black women suffer seven times more pregnancy-related deaths than white women. The COVID-19 pandemic has exacerbated these crises; people of color and pregnant people are at significantly higher risk of severe outcomes, including death, from COVID-19.
The death of a parent, harrowing in itself, is a traumatic loss for a child, as well as for partners, wider families, and friends. The emotional, social, and economic repercussions are immeasurable. That’s why health care advocates in New Jersey were determined to change this brutal narrative.
Extending postpartum Medicaid coverage is a principal recommendation of maternal mortality review committees in multiple states and has been endorsed by more than 275 organizations, including the American College of Obstetricians and Gynecologists (ACOG).
It was a key recommendation in the Nurture NJ Maternal and Infant Health Strategic Plan unveiled in 2021 by Tammy Murphy in concert with Gov. Phil Murphy, whose Fiscal Year 2022 budget allocated the required funding.
The federal government’s approval for extending postpartum Medicaid ensures that New Jersey can receive enhanced funding for costs related to certain eligible people. Medicaid extension, although critical, is not a cure-all; preventing the deaths of new parents requires additional solutions. So, the work must continue for additional legislation that will keep our families healthy and eliminate inequities in outcomes.
Thomas Westover, MD, is an obstetrician and maternal & fetal medicine specialist at Capital Health in Trenton and chair of the New Jersey section of the American College of Obstetricians and Gynecologists;
Patricia Suplee Ph.D, RNC, is an advanced practice nurse specializing in the care of pregnant and postpartum women and chair of the New Jersey section of the Association of Women’s Health, Obstetric and Neonatal Nurses.
Julie Blumenfeld DNP, CNM is a certified nurse-midwife in Trenton and president of the New Jersey Affiliate of the American College of Nurse Midwives.
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