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NH is extending Medicaid coverage for new moms

 A hospital room with a bed for an infant and medical equipment
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Advocates hope that extending postpartum Medicaid coverage will improve the health of new mothers and reduce maternal deaths, many of which are preventable.

New Hampshire will soon extend Medicaid coverage for new mothers to a full year, one of several provisions in the newly signed state budget that aim to improve maternal and child health.

Currently, postpartum coverage in New Hampshire lasts only 60 days. Supporters of the new change say it will provide continued access to health care during a critical period after childbirth.

Dr. Danielle Albushies, an OB-GYN in Bedford, said complications can arise months after pregnancy — including mental health struggles, a leading cause of maternal deaths in the U.S.

“When women lose their insurance at that 60-day mark, there is just a huge unsafe gap in the health care for those women where we can be making a difference,” she said.

"When women lose their insurance at that 60-day mark, there is just a huge unsafe gap in the health care for those women where we can be making a difference."
Dr. Danielle Albushies, an OB-GYN in Bedford

The coverage extension was part of a package of changes — which supporters dubbed the “Momnibus” — included in the two-year budget. The legislation also requires Medicaid to cover doulas, lactation services and donor breastmilk; provides funding for family resource centers; and expands mental health services for young kids.

State Sen. Becky Whitley, a Hopkinton Democrat who was the legislation’s lead sponsor, said the goal was to create a comprehensive network of support for new families.

“Anyone who's had a baby knows that postpartum issues are not just done after three months, right?” she said. “There are so many complications that can happen in that postpartum period that, without adequate support and services, can be left unaddressed.”

The New Hampshire Department of Health and Human Services anticipates the extended coverage will take effect this fall, after it receives federal approval, according to Jake Leon, a spokesman for the department.

Medicaid covers about four out of every 10 births nationwide, and around one-quarter of births in New Hampshire. At least 35 other states and Washington, D.C., have expanded postpartum coverage to one year since the 2021 American Rescue Plan Act authorized it, according to the Kaiser Family Foundation.

Rates of maternal mortality in the U.S. are far higher than in other wealthy countries. They also show a stark racial gap: Black women died from pregnancy-related causes at 2.6 times the rate of white women in the U.S. in 2021, according to the Centers for Disease Control and Prevention.

A 2022 CDC study of pregnancy-related deaths that occurred before, during and up to a year after childbirth found that more than 80% were preventable. Mental health conditions, including suicide and drug overdose, were the leading causes of death, followed by hemorrhaging, heart conditions and other medical complications.

Heather Martin’s sister died by suicide after giving birth 14 years ago. Now a medical assistant and maternal mental health advocate with Dartmouth Health, Martin said extending postpartum coverage will help more people access therapy and other care during a high-risk time.

“Studies have shown that moms have heightened depression, anxiety around the four-to-six-month postpartum period,” Martin said. “So to cut them off at that 60 days — it just can't happen.”

She said there’s increasing awareness of maternal mental health among families and medical professionals, but more education is needed. She said it’s important that pediatricians as well as OB-GYNs screen parents for mental health symptoms, and doulas can also play a role.

“They can lay eyes on them, and they can see if a mom's struggling,” she said. “They can talk to them and give them tools and strategies to help with their anxiety or depression. So it's not always finding a therapist, taking medication.”

If you or someone you know is experiencing a mental health crisis, help is available. The National Maternal Mental Health Hotline offers free, confidential support in English and Spanish at 1-833-TLC-MAMA (1-833-852-6262.) You can also call or text the National Suicide & Crisis Lifeline at 988.

Updated: June 27, 2023 at 12:01 PM EDT
This story was updated with additional information from the Department of Health and Human Services about when the policy change will take effect and how many births in New Hampshire are covered by Medicaid.
Paul Cuno-Booth covers health and equity for NHPR. He previously worked as a reporter and editor for The Keene Sentinel, where he wrote about police accountability, local government and a range of other topics. He can be reached at pcuno-booth@nhpr.org.
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