Mississippi extends postpartum Medicaid coverage

Mississippi is set to extend Medicaid coverage for new mothers, joining a wave of Republican-controlled states that have otherwise opposed a more broad expansion of the health care program.

A bill that would provide postpartum Medicaid coverage for 12 months, rather than 60 days, cleared the state House 89-29 and is headed to the desk of Gov. Tate Reeves (R), who said last week that he would sign it. The Senate previously passed the bill.

Mississippi Republicans took pains to stress that they were not expanding Medicaid eligibility, only extending coverage for people who qualified while they were pregnant. They also presented the measure as a way to show the state’s commitment to protecting the lives of infants and mothers in the aftermath of the Supreme Court ruling overturning the constitutional right to an abortion.

“I don’t believe that the issues surrounding the health of babies, both born and unborn, or women’s health should ever be political chess pieces,” Rep. Missy McGee (R) said on the House floor. “This bill demonstrates that we, as policy makers, also recognize that our commitment to life cannot end once the baby takes his or her first breath and is outside of the womb.”

The passage of postpartum Medicaid expansion in one of the most Republican states represents a sea change, after Republicans spent more than a decade organizing in opposition to a provision of the Affordable Care Act of 2010 that gave states federal matches for expanding their Medicaid populations.

“Today, our elected officials voted yes to save the lives of women and children and said no to divisive political talking points,” said Roy Mitchell, executive director of the Mississippi Health Advocacy Program, which supports Medicaid expansion. “By offering a bipartisan solution to Mississippi’s infant and maternal morbidity crisis, a diverse collective of Mississippi health advocates successfully bridged the disconnect in Mississippi between overwhelming public opinion and a Medicaid policy driven by ideology.”

Medicaid expansion has proven widely popular among Republicans and Democrats, and the federal government has offered new incentives for states to increase the number of people on their Medicaid rolls.

North Carolina is likely to become the 40th state to adopt Medicaid expansion after the state’s top legislative leaders said last week they reached a deal on a plan.

There are few signs that lawmakers in the remaining 10 states will budge on a broader Medicaid expansion anytime soon. Republican leaders at the state and federal levels have pushed for work requirements and Medicaid budget cuts in recent weeks.

But proposals limited to women and babies have found more traction in the GOP after the Dobbs vs. Jackson Women’s Health decision. Former President Donald Trump called for “baby bonuses” in a speech Saturday, and U.S. Sen. JD Vance (R-Ohio) floated federal legislation that would create universal pregnancy coverage.

The option to extend postpartum coverage for a full year was first offered as a temporary provision of the 2021 American Rescue Plan and made permanent by the consolidated Appropriations Act of 2023, which President Biden signed in December.

Mississippi will be the last of the 10 states that have not more broadly expanded Medicaid to adopt a postpartum extension. Wyoming became the ninth to do so when Gov. Gov. Mark Gordon (R) signed it into law Monday.

Reeves, who is facing a potentially competitive re-election this year, opposes Medicaid expansion but said last week he would support the postpartum extension as part of his “pro-life agenda.”

Reeves and House Speaker Philip Gunn (R), who spiked a similar bill last year after it passed the Senate, were the subject of an intense lobbying campaign from the far-right Freedom Caucus before the House vote. In an email circulated this week, the group accused Reeves of abandoning GOP free-market principals during an election year and urged supporters to join them in asking Gunn to block a vote on the bill, calling it an “attempt to expand Obamacare in Mississippi.”

“Nothing about Medicaid expansion fits into our party’s platform of stopping the expansion of government healthcare programs, supporting free-markets, and having greater individual responsibility,” the missive read.

Mitchell, of the Mississippi Health Advocacy Program, said he hoped to build on the postpartum extension to “bring health care coverage to more children, families and working Mississippians” in the so-called coverage gap of people who make too little to qualify for subsidized Marketplace coverage and too much to qualify for Medicaid.

To qualify for Medicaid in Mississippi, a pregnant woman must have an income below 194% of the federal poverty level, which is $26,364 for an individual,or $35,521 for a family of two.