The Medicaid program finances about 4 in 10 births in the U.S. Federal law requires states to provide pregnancy-related Medicaid coverage through 60 days postpartum. After that period, some postpartum individuals may qualify for Medicaid through another pathway, but others may lose coverage, particularly in non-expansion states. To help improve maternal health and coverage stability and to help address racial disparities in maternal health, a provision in the American Rescue Plan Act of 2021 gives states a new option to extend Medicaid postpartum coverage to 12 months via a state plan amendment (SPA). This new option took effect on April 1, 2022 and is available to states for five years. The Centers for Medicare and Medicaid Services (CMS) released guidance on December 7, 2021 on how states can implement this new option.
During the COVID-19 public health emergency (PHE), states must provide continuous coverage to Medicaid enrollees to be eligible for enhanced federal matching funds under the Families First Coronavirus Response Act. As a result, postpartum coverage has been continuous since the start of the coronavirus pandemic.
States that sought to implement extended postpartum coverage prior to April 1, 2022 have done so through a section 1115 waiver or by using state funds. This page tracks recent state actions to implement extended Medicaid postpartum coverage, including states that have implemented a 12-month postpartum extension, states that are planning to implement a 12-month extension, states with pending legislation to seek federal approval through a SPA or 1115 waiver, and states that have proposed or received approval for a limited coverage extension.
Medicaid Postpartum Coverage Extensions: Approved and Pending State Action as of November 17, 2022