An initiative to introduce a proposal for expanding Medicaid for new parents has resurfaced in the Wisconsin State Senate and Assembly. The proposal outlines an extension of postpartum Medicaid coverage from 60 days to a year for low-income families, according to Wisconsin Public Radio.
This extension is presented as an option by Congress for states to accept federal funds potentially aligning coverage with periods of care recommended by medical professionals. This care includes both mental and physical healthcare which is crucial in the fight against maternal mortality rates. The bill is approved by every state aside from Wisconsin and Arkansas and has been linked to reduced financial stress on low-income parents, according to Wisconsin Public Radio.
Though this bill was previously proposed, it has not yet gone to a vote in the State Assembly despite bipartisan support. A version of this bill was also introduced as part of Gov. Tony Evers’ 2021-2023 State Budget Proposal, but negotiations with the Republican Joint Finance Committee changed the coverage period from 12 months to 90 days. This proposal was then blocked by the Federal Centers for Medicare and Medicaid Services because it would not be accepted for less than the full coverage period.
Some Republican legislators are in support of this bill because it aligns with pro-life ideology in encouraging people to turn away from abortion if they are guaranteed coverage during the first year of a child’s life, according to Wisconsin Watch. The bill was introduced by Rep. Patrick Snyder (R-Wis.) who doesn’t see it as partisan, but instead is focused on funding patient care, according to Wisconsin Public Radio.
A major opponent of this bill is Assembly Speaker Robin Vos (R-Wis.) who has stated he does not support policies that expand Medicaid in any way. In 2023, he spoke about how he is glad people choose to have children, but it shouldn’t be the responsibility of the taxpayers to fund the child’s delivery, according to Wisconsin Watch. Vos prevented the bill from reaching a hearing in the Assembly last February by refusing to schedule it before adjourning the session.
The most cited argument in opposition revolves around the cost of the expansion. According to a fiscal assessment completed in the previous session, $8.4 million a year in state taxpayer funds would be used for the bill while federal taxpayers would cover the remaining $21.4 million a year.
Proponents argue this price is not an overextension of assistance but rather an investment in the health of Wisconsin communities. Supporters like former Representative Donna Rozar (R-Wis.) believe the short-term cost is justified by potential positive outcomes for the community. According to Wisconsin Public Radio, in her and many other’s minds, investing in the parents means investing in the children as well as the future of healthy communities. From a human dignity standpoint, spending the money now saves money down the road. The expansion’s successes in other states prove the benefits and necessity of a longer coverage period.
Research done through the National Library of Medicine on the effects of this expansion in Colorado in comparison to the lack of expansion in Utah between 2013 and 2015 highlights the positive impact of the expansion on new parents. The study found that people in Colorado received improved coverage stability compared to women in Utah over the year postpartum.
This impact was seen and magnified in Colorado regarding those experiencing severe maternal morbidity with rates of nearly 50% more postpartum Medicaid-financed outpatient visits compared to Utah. This data supports proponents’ claims that increasing care has the greatest impact on those in high-risk situations who were already receiving benefits but were then able to extend coverage to better support their postpartum health. Postpartum mental health would also be a focus of this expansion.
Additional research in Colorado done by Georgetown University studied the impact of this coverage increase, researching whether an individual chose to stay on Medicaid for 12 months compared to those who transitioned to commercial insurance. They found staying enrolled in Medicaid compared to commercial coverage correlated with a 20.5 % increase in the amount of outpatient mental health visits or needing prescription medication for mental health issues during the year postpartum.
Similar findings were found in research done on the expansion of Medicaid in Oregon, which found expanding care linked to a 3.64%-point increase in postpartum depression screening 6 months postpartum, according to Frontiers in Health Services. These research points emphasize the positive impact expanded coverage has on low-income communities. For Wisconsin to stay consistent with the rest of the nation regarding postpartum support, the state legislature should further consider this bill.
Despite the increasingly clear evidence and bipartisan support for this legislation, working with Vos to consider a vote on the bill will prove difficult for legislators. These individuals, however, must not be dissuaded by the challenge and must continue to fight for this expansion. Not only for its life-saving impacts but because continued coverage stability and improvement on mental health can greatly better the quality of life across low-income communities.
