Illinois has become the first state in the country to extend full Medicaid plan benefits to mothers for one year after giving birth.
The Centers for Medicare & Medicaid Services approved the state’s request for a 1115 waiver to expand Medicaid coverage from 60 days postpartum to 12 months. Effective Monday, this approval is authorized through Dec. 31, 2025.
President Joe Biden’s recently enacted American Rescue Plan provides a pathway for states to extend postpartum coverage through Medicaid and the Children’s Health Insurance Program. Through this option, women can receive comprehensive Medicaid benefits after having a baby and not just pregnancy-related benefits.
Illinois projects that approximately 2,500 women annually, with incomes up to 208% of the federal poverty level, will receive a year of continuous Medicaid coverage as a result of the waiver.
“Continuous healthcare coverage reduces healthcare costs and improves outcomes,” said Secretary of Health and Human Services Xavier Becerra in a news release. “By expanding Medicaid eligibility for a full year after delivery, Illinois is setting an important model for other states across the country to follow.”
Disruptions in Medicaid coverage are common, and the postpartum period is a particularly high-risk time, according to a brief from the Assistant Secretary for Planning and Evaluation published in April. About 55% of women with Medicaid coverage at delivery experience a coverage gap in the next six months, as compared with 35% of those with private insurance.
Maternal outcomes in the United States are notoriously poor, with the rate of maternal mortality jumping from 17.4 deaths per 100,000 live births in 2018 to 20.1 the year after, according to the most recently available data from the Centers for Disease Prevention and Control.
Comparing the rate of maternal deaths in the U.S. with that of other developed countries puts these figures into perspective. The U.S. rate was more than double that of countries like the United Kingdom, Australia and Switzerland, a study by The Commonwealth Fund shows.
As with other healthcare conditions, Black women in the U.S. face the highest risk postpartum. The maternal mortality rate for Black women was 44 deaths per 100,000 live births, which is about 2.5 times the rate for white women (17.9) and 3.5 times the rate for Hispanic women (12.6), according to CDC data.
In Illinois, that gap is especially high, with a 2018 state report showing that Black women are six times as likely to die of a pregnancy-related condition as their white counterparts.
Though Illinois is the first state to take the plunge into extending Medicaid coverage postpartum, it will not be the last. At least five states have pending 1115 waiver requests to expand those benefits: Georgia, Indiana, Missouri, New Jersey and Texas.
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