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Virginia’s Medicaid Agency Works To Ensure Postpartum Coverage

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This month, Virginia’s Medicaid agency began automatically enrolling women in postpartum health insurance coverage. Before Medicaid expansion in Virginia, many pregnant women received health care coverage during pregnancy, but were automatically unenrolled from Medicaid 60 days after they gave birth.

Even though Medicaid expansion extended coverage to pregnant women well beyond 60 days postpartum, enrollment in that coverage hasn’t been automatic until now.

“The last thing that we want them [new moms] to worry about is their coverage accidentally getting dropped or having to reapply for health insurance or having a delay or a gap in their health insurance simply because they're changing aid categories,” said Rachel Pryor, deputy director of administration with Virginia’s Medicaid agency.

The postpartum period is one of the most vulnerable times for pregnant women. A recent state report found that of all pregnant women who died within a year of childbirth from 1999 to 2012, over half died beyond 60 days postpartum.

The report was part of Virginia’s first ever comprehensive look at the connection between maternal mortality rates and chronic health conditions. It found that African American women with at least one chronic health condition, like diabetes or mental illness, were more than twice as likely to die around the time of their pregnancy. And of all of the women who died, few were referred to a specialist.

“75% of the women did not receive a referral to a specialist to manage their chronic condition,” said Melanie Rouse, maternal mortality projects coordinator with the state’s office of the chief medical examiner. 

Rouse says that number is alarming. That’s why her department has recommended that all Virginia hospitals have at least one person on hand to help coordinate specialist referrals for pregnant women, among other recommendations.