New data from the Arkansas Department of Human Services (DHS) reveals what advocates have warned: Arkansas’s refusal to extend Pregnancy Medicaid coverage to 12 months postpartum is leaving thousands of mothers without critical health insurance coverage just weeks after giving birth.
Arkansas has the highest maternal mortality rate in the U.S. Yet, we are the only state that has refused to extend Pregnancy Medicaid postpartum coverage. In Arkansas, Pregnancy Medicaid ends 60 days after giving birth. This is before many women’s bodies have fully healed from childbirth. One of the Governor’s arguments against the extension is that Pregnancy Medicaid coverage is unnecessary because other options exist for all women. Now, we have even more concrete evidence disproving this.
The background: Earlier this year, the legislature passed Act 161 of 2024. It requires DHS to report quarterly to the legislature on the number and types of transitions from Pregnancy Medicaid. DHS was scheduled to provide this report to the Senate and House Committee on Public Health, Welfare, and Labor on October 28. An official written report was not finished at that time. Instead, DHS officials gave a preliminary verbal report to the committee. What we learned set off alarms.
DHS reported that at the end of the 3rd quarter (September 30, 2024), 4,234 women were enrolled in Medicaid’s pregnancy category when they gave birth. However, nearly 40% of these women lost their health coverage when their Pregnancy Medicaid ended at 60 days postpartum. Many lost coverage even before the 60-day postpartum period ended.
Here’s the breakdown:
- 1,711 women stayed in the same category of Medicaid coverage (stayed insured)
- 901 moved to a different category of Medicaid coverage (stayed insured)
- 1,451 were deemed no longer eligible and removed (lost insurance)
- 171 were removed for “unknown reasons” before the 60 days postpartum period (lost insurance)
In other words, 38.1% of Medicaid-insured moms lost Medicaid by 60 days postpartum. Even more alarming, 171 women lost coverage before the 60 day mark. DHS had no clear explanation for these early removals from Pregnancy Medicaid. However, DHS officials stated they are investigating this smaller number of cases. Some postpartum women may move into the marketplace. Most are likely losing insurance entirely. We know this was the case for children who lost Medicaid coverage during the unwinding.
The data presented confirms what maternal health advocates have known all along: the state’s limited Pregnancy Medicaid policy is failing our postpartum mothers. For this reporting period alone, from July to September, over one-third of women in the program were left without coverage as they continue to recover from childbirth and face potential health complications.
Why does this matter? The first year after giving birth is a vulnerable time. Many health complications can arise in the months after delivery. Postpartum depression and cardiovascular issues are major health risks for new moms in Arkansas. For those without care, treatable issues can become life-threatening.
The Governor continues to argue that the women who are no longer eligible for Pregnancy Medicaid have other options. But it is not that simple. For many families, health care coverage alternatives to Pregnancy Medicaid are simply out of reach, leaving new mothers to face postpartum health challenges alone. Options like purchasing private insurance on the Health Insurance Marketplace are not affordable for many people. They can also be complicated to navigate, especially since the state has banned insurance navigators. And many women discover they’ve lost Medicaid coverage only when they try to schedule medical appointments or pick up a prescription.
Changing postpartum moms’ insurance just weeks after they give birth can disrupt care and coverage of critical services. Changing insurance often means finding new providers that accept their new insurance. It’s the wrong time to make mothers with newborns enroll in a new insurance program and potentially find new doctors.
Arkansas Advocates will be watching for the release of the official report to review if the final data changes. But one thing is clear. If Arkansas wants to reduce maternal deaths and support women’s health, we must expand postpartum Medicaid to 12 months.