Bill Overview
Title: Advancing Maternal Health Equity Under Medicaid Act
Description: This bill provides a 90% federal matching rate for Medicaid maternal health care expenditures that exceed 2021 levels. Qualifying services must be provided by maternity care providers or perinatal health workers (e.g., doulas) and include prenatal and postpartum telehealth services, home visits, and behavioral health care.
Sponsors: Rep. Manning, Kathy E. [D-NC-6]
Target Audience
Population: Women in the United States on Medicaid who are pregnant or postpartum
Estimated Size: 3000000
- Medicaid is a government program that provides health coverage to low-income individuals and families, so this legislation will primarily affect low-income women who are pregnant or have recently given birth and are covered by Medicaid.
- The bill focuses on maternal health care, meaning it will specifically impact pregnant and postpartum women who depend on Medicaid for their health services.
- The inclusion of services such as prenatal and postpartum telehealth, home visits, and behavioral health care implies a focus on comprehensive and accessible maternal care, impacting women who require these services.
- Medicaid is a program available in all U.S. states, so this legislation would affect women across the country who meet the qualifications.
- Data from the CDC and Medicaid reports allows us to estimate the population of women on Medicaid who are pregnant or postpartum.
Reasoning
- The target population consists of low-income women on Medicaid who are pregnant or postpartum. This includes a diverse range of backgrounds in terms of age, race, and location across the U.S., as Medicaid is a nationwide program.
- While the policy provides a significant federal matching rate and funding, it is meant to only surpass 2021 levels, suggesting that it helps to expand services but not to an unlimited extent.
- We need to consider the variation in access to existing maternal health services and disparities that exist in different states when projecting the impact of this policy.
- Some women might not use extra services provided due to availability issues or personal choice, while others may benefit significantly by accessing additional services like telehealth, home visits, and behavioral healthcare.
- To ensure a realistic sample, some women should not be directly impacted by the policy, highlighting the limits of its reach and implementation challenges.
Simulated Interviews
Retail Worker (Jackson, Mississippi)
Age: 28 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 15/20
Statement of Opinion:
- I have been struggling with healthcare access during and after my pregnancy due to the limited resources in my area.
- The new policy sounds promising, especially the home visits and telehealth options which are hard for me to access due to my location.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 7 | 5 |
Teacher (Chicago, Illinois)
Age: 35 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 18/20
Statement of Opinion:
- I think it's great that maternal health services are expanding, although I may not use many of them as we have some coverage through my husband's job.
- The behavioral health aspect sounds helpful.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
Student (San Antonio, Texas)
Age: 22 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 16/20
Statement of Opinion:
- I am really worried about managing my pregnancy and school deadlines.
- This policy is encouraging because it could make access to healthcare more affordable and nearer with services like telehealth.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 6 | 4 |
| Year 10 | 7 | 4 |
| Year 20 | 6 | 4 |
Freelance Writer (Boise, Idaho)
Age: 31 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 3.0 years
Commonness: 12/20
Statement of Opinion:
- I see the potential in this policy for other mothers around me who are more dependent on Medicaid than I am.
- For me, the extra mental health support through accessible means could be beneficial.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 8 | 7 |
| Year 20 | 8 | 7 |
Unemployed (Los Angeles, California)
Age: 26 | Gender: female
Wellbeing Before Policy: 3
Duration of Impact: 20.0 years
Commonness: 14/20
Statement of Opinion:
- Language is a big barrier for me accessing healthcare, and I hardly understand what resources are available.
- Increasing accessible healthcare services, including telehealth, in my language would really make a difference.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 3 |
| Year 2 | 5 | 3 |
| Year 3 | 6 | 3 |
| Year 5 | 7 | 3 |
| Year 10 | 8 | 3 |
| Year 20 | 8 | 3 |
Cashier (Atlanta, Georgia)
Age: 29 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 17/20
Statement of Opinion:
- I absolutely need to have more check-ups to monitor my pregnancy due to my blood pressure, and this policy sounds like it might help with that.
- The additional federal support is necessary for states to be able to expand services.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 7 | 5 |
Part-time Barista (New York, New York)
Age: 38 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 14/20
Statement of Opinion:
- In the city, healthcare options are plentiful but expensive, particularly for postpartum care.
- I'm hopeful this policy will alleviate some of the financial burdens.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 6 |
Nursing Assistant (Miami, Florida)
Age: 24 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 16/20
Statement of Opinion:
- I hope the policy will make a positive change in my community where access to qualified healthcare professionals can be limited.
- Especially for new mothers like me, more support in this period is crucial.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 8 | 4 |
| Year 10 | 8 | 4 |
| Year 20 | 8 | 4 |
Clerk (Phoenix, Arizona)
Age: 41 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 11/20
Statement of Opinion:
- I’ve had my fair share of complications and know that improvements are needed; whether a policy can actually deliver is another matter.
- Still, ideas of improving maternal care through this initiative could be positive if executed well.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 7 | 6 |
Homemaker (Detroit, Michigan)
Age: 32 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 15.0 years
Commonness: 13/20
Statement of Opinion:
- Twins mean double the worry, double the appointments.
- If the proposed healthcare expansions help cover more expenses, it will ease some of my worries.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 8 | 4 |
| Year 20 | 8 | 4 |
Cost Estimates
Year 1: $2700000000 (Low: $2200000000, High: $3300000000)
Year 2: $2730000000 (Low: $2230000000, High: $3330000000)
Year 3: $2760000000 (Low: $2260000000, High: $3360000000)
Year 5: $2820000000 (Low: $2320000000, High: $3420000000)
Year 10: $3000000000 (Low: $2500000000, High: $3600000000)
Year 100: $3600000000 (Low: $3100000000, High: $4200000000)
Key Considerations
- The bill's cost depends heavily on the difference between new expenditures and the 2021 baseline.
- States may need to adjust infrastructure and administrative processes to effectively implement the new services and federal matching.
- The demand for qualifying services could exceed expectations, leading to higher-than-anticipated costs.
- Long-term cost savings from improved maternal health outcomes are possible but are not directly accounted for in current estimates.