The Centers for Medicare & Medicaid Services (CMS) unveiled its Maternity Care Action Plan to support the implementation of the Biden-Harris Administration’s Blueprint for Addressing the Maternal Health Crisis. The action plan takes a holistic and coordinated approach across CMS to improve health outcomes and reduce inequities for people during pregnancy, childbirth, and the postpartum period. CMS’ implementation of the action plan will support the Biden-Harris Administration’s broad vision and call to action to improve maternal health.
“Strengthening maternal health is key to strengthening the health and wellbeing of communities across America,” said HHS Secretary Xavier Becerra. “At HHS, we are taking unprecedented action to advance the Biden-Harris Administration’s vision to improve maternal health and tackle disparities, and I’m proud of the bold action plan CMS has laid out to contribute to our goals. Today is just the beginning: we will tirelessly work to make sure all mothers get the care and support they need.”
Through the action plan, CMS Administrator Chiquita Brooks-LaSure also encouraged industry stakeholders – including health care facilities, insurance companies, state officials, and providers – to consider key commitments the private sector can make to improve maternal health outcomes. Industry can submit proposed commitments at http://cms.gov/maternalhealthcommitments.
“The United States is facing a worsening maternal health crisis,” said CMS Administrator Brooks-LaSure. “Enough is enough. We can – and will – do better. CMS will use every available lever to support people during pregnancy, childbirth, and the postpartum period, and advance health equity across the country. Our action plan is built on promising approaches, like extending postpartum coverage in Medicaid, which already covers more than 40 percent of births nationwide, to advance equitable, high-quality maternity care and reduce unnecessary maternal illnesses and deaths.”
In addition to today’s action plan, CMS approved new actions in Connecticut, Kansas, and Massachusetts to extend Medicaid and Children’s Health Insurance Program (CHIP) coverage for 12 months after pregnancy. As a result, up to an additional 19,000 people annually in these states – including 4,000 in Connecticut; 7,000 in Kansas; and 8,000 in Massachusetts – will have access to Medicaid or CHIP coverage for a full year after pregnancy.
This extension of coverage was made possible by a new state plan opportunity established by the American Rescue Plan. The states extending postpartum coverage today join California; Florida; Illinois; Kentucky; Louisiana; Maine; Michigan; Minnesota; New Jersey; New Mexico; Oregon; South Carolina; Tennessee; Virginia; Washington, D.C.; and Washington state in extending Medicaid and CHIP coverage from 60 days to a full 12 months after pregnancy. Now, during the Biden-Harris Administration, an estimated 284,000 parents are eligible for 12 months of postpartum coverage through Medicaid and CHIP extensions. If all states adopted this option, as many as 720,000 people across the United States annually could be guaranteed Medicaid and CHIP coverage for 12 months after pregnancy.
Access to care across the lifespan is crucial to women’s health and birth outcomes. In light of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, which overturned Roe v. Wade, CMS is working to ensure access to the full range of reproductive health care services — including IUDs, emergency contraception, other forms of contraception, and abortion care within the agency’s legal authority (in cases where the individual’s life is in danger, or in cases of rape or incest).
CMS also took another significant step toward improved maternity care by outlining its proposal for a “Birthing-Friendly” hospital designation, a key feature of the maternal health strategy, in the 2023 Inpatient and Long-term Care Hospital Prospective Payment System proposed rule released this year. The designation would be publicly displayed on a CMS website to provide information to consumers on hospitals that have demonstrated a commitment to maternity care quality by implementing best practices that advance health care quality, safety, and equity for pregnant and postpartum patients.
Initially, the designation would be awarded to hospitals based on their reporting of the Maternal Morbidity Structural Measure in the Hospital Inpatient Quality Reporting (IQR) Program. The proposed rule also introduces two additional maternal health quality measures for the Hospital IQR Program regarding low-risk Cesarean deliveries and severe obstetric complications.
Postpartum coverage extensions, the new “Birthing-Friendly” hospital designation, and additional quality measures are just several of the diverse tools comprising the CMS Maternity Care Action Plan, including:
- Coverage and Access to Care: CMS is working to improve access to comprehensive health coverage, including for those eligible through Medicaid and CHIP, the Health Insurance Marketplace®, and Medicare coverage; and to help ensure continuity of coverage from before, during, and after pregnancy.
- Data: CMS is working to expand its data collection efforts, build a better understanding of key demographic drivers of health to identify disparities in care or outcomes, and coordinate across programs to identify gaps and best practices.
- Quality of Care: As we develop new policy, CMS will engage with people with lived experience, and work with states, providers, and other key stakeholders to improve the quality of care that Medicaid and CHIP, Medicare, and Health Insurance Marketplace® enrollees receive during pregnancy, childbirth, and postpartum.
- Workforce: CMS will work with states and sister agencies to identify opportunities to expand and improve access to a diverse maternity care workforce, including midwives and community-based practitioners, such as doulas and community health workers.
- Social supports: CMS will work to build connections between the care and supports CMS programs cover and the social supports provided by other federal, state, and local partners, with the goal of providing whole-person care to pregnant and postpartum enrollees.
For more information on CMS plans and programs, consult the maternal health action plan in its entirety on CMS.gov.