Medicaid’s Crucial Role in Combating the Maternal Mortality and Morbidity Crisis
The United States is in the throes of a maternal health crisis. It is the only developed country where the maternal mortality rate has been steadily rising and, for every woman who dies from pregnancy-related causes, another 70 suffer from severe maternal morbidity. Black and American Indian/Alaska Native women in the United States are 3.3 and 2.5 times, respectively, more likely to die from pregnancy-related causes than non-Hispanic white women.
Medicaid has a crucial role to play in developing solutions. Nearly half of all U.S. births are financed by Medicaid, and women enrolled in Medicaid are more likely than their privately-insured counterparts to be at higher risk for poor maternal outcomes. Additionally, compared with women with private insurance at delivery, those covered by Medicaid are more likely to be Black— the women who are most affected by the crisis.
On March 11, State Health & Value Strategies (SHVS) hosted a webinar in which experts from Manatt Health explored Medicaid strategies to improve maternal health outcomes and address disparities in five key domains: coverage, enrollment, benefits, models of care, and quality improvement. This webinar shared findings from a published Manatt Health issue brief for SHVS on Medicaid’s role in combating the maternal mortality crisis.
On December 6, the Centers for Medicare & Medicaid Services published and made effective an interim final rule (IFR) with comment period regarding states’ ongoing unwinding efforts to redetermine eligibility for all Medicaid enrollees nationwide. This expert perspective summarizes the IFR, which interprets and implements the state reporting requirements and CMS enforcement authorities that Congress enacted last winter in the Consolidated Appropriations Act of 2023.
The 11th annual open enrollment period (OEP) is underway, providing consumers with an opportunity to enroll in health coverage for plan year 2024 through the Affordable Care Act Marketplaces. To support consumers during this OEP, State-Based Marketplaces (SBMs) are innovating to make health coverage more affordable and easier for consumers to enroll. This expert perspective highlights new initiatives being implemented by SBMs during the plan year 2024 OEP, including establishing or improving state subsidy programs to reduce out-of-pocket costs, expanding coverage for undocumented populations, or implementing policies to improve the enrollment process.
As the unwinding of the Medicaid continuous coverage requirement continues, both states and the federal government are tracking and monitoring the impacts of the resumption of eligibility redeterminations and disenrollments. Given the time-lags and caveats of CMS data, many states are publishing their own state data dashboards. To date, 46 states (including the District of Columbia) have released unwinding data in either an interactive dashboard or static pdf format, or are making public their required CMS Monthly Unwinding Data reports. This expert perspective includes an interactive map with links to state reporting, as well as a table tracking the unwinding indicators and disaggregated data that states are reporting on. SHVS will continue to update this EP as more states publish their unwinding data.