The 116th Congress closed in January on a disappointing note for maternal health advocacy. Two maternal health bills that cleared the House of Representatives with bipartisan support in September 2020 failed to reach the Senate floor for a vote, sending legislators back to the drawing board.
Despite this setback, the general outlook for maternal health advocacy is positive. President Biden has pledged to make women’s health issues a key part of his agenda, and Vice President Harris is well known for her support of maternal health legislation in the Senate, particularly that affecting Black and minority women.
Biden’s pick for HHS Secretary, Xavier Beccera, has a long track record of supporting women’s health and the rights of the underserved in his stint as California Attorney General. His wife, Carolina Reyes, is a maternal-fetal specialist whose expertise includes complicated pregnancies and prenatal care.
The president’s choice for Surgeon General, Vivek Murthy, formerly served as the Surgeon General from 2014 to 2017 and is no stranger to public health crises. He is a strong advocate for mental health support, an issue that is critical for the maternal health field.
So what can the maternal health field expect from Capital Hill in the coming months?
The new administration has voiced support for initiatives introduced under the Trump administration, like former HHS Secretary Alex Azar’s Action Plan to improve maternal health and former Surgeon General Jerome Adams’ Call to Action for maternal health; and a Democratic-controlled Congress — with the highest percentage of female legislators in history — offers maternal health care policies a clearer and more expedient pathway into law.
We are likely to see the 117th Congress take up issues from its predecessors, particularly the two bills that cleared the House in the fall of last year: the MOMS (Helping Medicaid Offer Maternity Services) Act of 2019, which focused on expanding Medicaid coverage through 1 year postpartum and funding research on Medicaid coverage for doula care; and the Maternal Health Quality Improvement Act of 2019, which focused on supporting training for clinicians on implicit bias and health equity, broadening the obstetric workforce in rural communities, and providing funding for states to enhance data collection and strengthen perinatal quality collaboratives.
Expect postpartum Medicaid expansion to garner focus and attention in the coming months, as the issue has gained considerable bipartisan momentum over the past several years. Under the current system, while all states must provide health coverage to pregnant women on Medicaid with income up to at least 138% of the federal poverty level up through 60 days postpartum, there are gaps in coverage after that timeframe in many states.
At a time when new mothers are most vulnerable (33% of 700 annual pregnancy-related deaths in the U.S. occur after the first 6 weeks postpartum), those on pregnancy Medicaid are in danger of having their health insurance dropped if they live in one of 12 states. In these states, the threshold to qualify for Medicaid as a parent is higher than as a pregnant woman.
The future of maternal health is promising, but the momentum needs to continue to affect real changes. Stakeholders across the spectrum need to be sharing their expertise and leverage to get maternal health issues in front of policymakers on both sides of the aisle.