Harris right that Biden administration expanded postpartum Medicaid coverage to 43 states

Kamala Harris

Statement: Postpartum Medicaid coverage expanded from three states to 43 because of the Biden administration.

During an interview with Noticias Univision, Vice President Kamala Harris touted the Biden administration’s efforts to extend postpartum Medicaid care.

"When I came in as vice president, only three states extended postpartum care Medicaid coverage to 12 months. I issued a call and a challenge to all states. And now 43 states have extended postpartum care for women," she said Jan. 29.

Postpartum health insurance covers a critical period for recovering from childbirth, which the Centers for Medicare & Medicaid Services says includes addressing complications of delivery, ensuring mental health, managing infant care and transitioning from obstetric to primary care.

Federal law previously required states to provide pregnancy-related Medicaid coverage until 60 days postpartum. Then 2021 legislation temporarily gave states the option to extend that coverage to a full calendar year. Legislation in 2022 gave states the option to make the extension permanent.

States offer this coverage using federal funding and the state’s own money.

Health experts told PolitiFact that Harris’ claim — on the numbers she cited and the administration’s role — is correct.

Coverage increased from three to 43 states

When contacted for comment, Harris’ office sent PolitiFact two sources to support the vice president’s claim.

The first was a Medicaid Postpartum Coverage Extension Tracker from KFF, a health policy research and analysis organization. It shows that 43 states have extended Medicaid coverage to 12 months postpartum.

Harris’ office also shared U.S. Department of Health and Human Services information showing that when President Joe Biden took office in January 2021, Illinois, New Jersey and Virginia were the only states in which Medicaid subsidized 12 months of postpartum coverage.

Did the Biden administration influence the expansion?

Different laws that Biden signed gave states an easier pathway and some federal money for this expansion. States still partially fund the care, as they did before the expansion.

The 2021 American Rescue Plan, which Biden signed into law, enabled states to temporarily extend Medicaid coverage to 12 months postpartum. The extension began April 1, 2022, and ended last May.

KFF reported that before April 2022, states that wanted to use federal money to expand postpartum care had to do so through a Section 1115 waiver. The waiver lets states divert money from what’s required by federal statutes and try new approaches for administering Medicaid. But the waivers allowed for only temporary changes. States could also use only state money to expand postpartum programs, rather than go through the waiver process.

"What the Biden administration did was create a new, arguably easier, pathway through a state plan amendment," said Maria W. Steenland, a Brown University assistant professor of population studies. Under these plan amendments, facilitated by the American Rescue Plan, the federal government and states agree on how to administer the Medicaid program.

Later, the 2022 Consolidated Appropriations Act, which Biden signed into law in 2023, gave states the option to permanently extend postpartum coverage to 12 months.

States that choose to make this coverage permanent cover those costs using federal and state money.

"The postpartum extensions are jointly funded with federal and state funds, just as all pregnancy-related coverage is under Medicaid," said Usha Ranji, KFF associate director of women’s health policy. Ranji added that the 2021 and 2022 laws did not change the financing arrangement for pregnancy-related coverage.

Many states previously wanted postpartum care expansion

A 2020 study on the impact of extending postpartum Medicaid found that although many states were interested in extending postpartum care, some had not because doing so required getting the temporary Section 1115 waiver or using state money.

Experts said that because the postpartum care expansion is still relatively new, it’s not possible yet to measure whether it has reduced postpartum hospitalizations and improved maternal mortality rates.

Steenland co-authored a study that found a 17% reduction in hospitalizations during the first 60 days postpartum was associated with the Medicaid expansions. The study also found evidence of a smaller decrease in hospitalizations from 61 days to six months postpartum.

PolitiFact's ruling

Harris said postpartum Medicaid coverage expanded from three states to 43 because of the Biden administration.

In 2021, when the Biden administration took office, Illinois, New Jersey and Virginia were the only states that had 12 months of postpartum Medicaid coverage. Now, 43 states have it.

Biden signed a 2021 law that allowed states to temporarily expand Medicaid postpartum coverage until May 2023, using a combination of federal and state money. A law Biden signed in 2023 enabled states to make the expansion permanent.

We rate this claim True.

Our sources

• Univision, Inmigración, frontera y economía: Univision habla con Kamala Harris de temas de la comunidad hispana, Jan. 29, 2024

• KFF, Medicaid Postpartum Coverage Extension Tracker, Jan. 17, 2024

• Medicaid and CHIP Payment and Access Commission, Legislative Milestones in Medicaid and CHIP Coverage of Pregnant Women, accessed Feb. 1, 2024

• CNN, To help tackle US maternal health crisis, more states extend Medicaid postpartum coverage, Jun. 21, 2023

• KFF, Postpartum Coverage Extension in the American Rescue Plan Act of 2021, Mar. 18, 2021

• National Library of Medicine, Extending Postpartum Medicaid: State and Federal Policy Options during and after COVID-19, Jun. 1, 2021

• KFF, Medicaid Waiver Tracker: Approved and Pending Section 1115 Waivers by State, Jan. 23, 2024

• CMS.gov, Biden-Harris Administration Announces the Expansion of Medicaid Postpartum Coverage in Oklahoma; 30 States and D.C. Now Offer a Full Year of Coverage After Pregnancy, Mar. 23, 2023

• The American College of Obstetricians and Gynecologists, Extend Postpartum Medicaid Coverage, accessed Jan. 31, 2024

• Health Affairs, Medicaid Expansion Led To Reductions In Postpartum Hospitalizations, accessed Jan. 31, 2024

• Phone interview with Maria W. Steenland, Jan. 31, 2024

• Email interview with Rachel Gandell Tetlow, senior director of Government and Political Affairs, the American College of Obstetricians and Gynecologists, Jan. 31, 2024

• Email interview with Ernesto Apreza, Deputy Press Secretary at the Office of the Vice President of the United States, Jan. 30, 2024

• Phone interview with Usha R. Ranji, associate director of women’s health policy at KFF, Jan. 31, 2024

• U.S. House of Representatives Black Maternal Health Caucus, Black Maternal Health Momnibus, accessed Jan. 31, 2024

• Medicaid.gov, Medicaid State Plan Amendments, accessed Jan. 31, 2024

• National Academy for State Health Policy, State Efforts to Extend Medicaid Postpartum Coverage, Feb. 1, 2024

• U.S. Department of Health and Human Services, Thousands More People with Medicaid and CHIP Coverage Now Eligible to Access Critical Postpartum Coverage Thanks to the American Rescue Plan, Apr. 1, 2022

• Idaho Capital Sun, Postpartum Medicaid expansion is the first step to maternal health equity, experts say, Apr. 1, 2023

• Medicaid.gov, Medicaid State Plan Amendments, accessed Feb. 1, 2024

• National Health Law Program, Primer: State Plan Amendments v. Section 1115 Waivers, May. 20, 2021

• Medicaid, Financial Management, accessed Feb. 7, 2024

This article originally appeared on Austin American-Statesman: Biden administration expanded postpartum Medicaid help to 43 states