Medicaid’s Crucial Role in Combating the Maternal Mortality and Morbidity Crisis
Patti Boozang, Chiquita Brooks-LaSure, and Gayle Mauser, Manatt Health
Medicaid has a pivotal role in improving national health outcomes for pregnant and postpartum women. Nearly half of all U.S. births are financed by Medicaid. Medicaid-enrolled pregnant women are more likely than women enrolled in private coverage to have had a preterm birth, to have had a low birthweight baby, and to experience certain chronic conditions (e.g., diabetes)—putting them at higher risk for poor maternal outcomes. States have flexibility to shape Medicaid policy related to maternal care, including who is covered, the duration of their coverage, the benefits they receive, and the delivery system through which they receive care. Further, state Medicaid agencies, in partnership with sister agencies, can use their purchasing power and “bully pulpit” to drive broader policy and cultural change to improve maternal health outcomes and the lives and health of mothers and of their children.
This issue brief, developed by our colleagues at Manatt Health, describes select policy and strategy levers that Medicaid agencies can employ to improve maternal health outcomes and address outcome disparities in five areas: coverage, enrollment, benefits, models of care, and quality improvement. In some cases, the Medicaid agency will be responsible for implementing these policies; in other cases, the Medicaid agency can lead collaboration with other state agencies such as the public health department or the state marketplace.
On March 11, State Health and Value Strategies hosted a companion webinar that highlighted and discussed select strategies from the issue brief.
On March 10, 2025, the Centers for Medicare & Medicaid Services released a proposed regulation that makes several policy and operational changes to the Affordable Care Act Marketplaces and insurance rules. This expert perspective reviews provisions of the proposed rule to assess their impact on State-Based Marketplaces and state insurance regulators.
Congress is considering a variety of federal policy changes that will have significant impacts on the Medicaid program, widely expected to reduce enrollment and federal Medicaid funding to states. A variety of state-level estimates have been released, which can be helpful for states as they consider how various policy proposals might impact their Medicaid programs. This expert perspective highlights state agencies that have estimated and quantified the potential impacts of various proposals on enrollment and spending. SHVS will continue to regularly monitor published estimates from states and update this expert perspective.