YES to extending postpartum Medicaid coverage

Written Testimony in Support of Senate Bill 639 and Senate Bill 698, submitted by Tracy Russell, Executive Director, Nurture KC

Chairman White, Vice-Chairwoman Gannon and members of the Seniors, Families, Veterans and Military Affairs Committee:

My name is Tracy Russell and I serve as the Executive Director of Nurture KC, an organization committed to reducing maternal and infant mortality in Kansas City. Nurture KC has 1 of 101 federal Healthy Start programs in the nation and the only urban program in Missouri. Healthy Start utilizes a community health worker model to serve 700 mothers and babies residing in the 14 ZIP codes of Kansas City with the highest rates of infant mortality.

Nurture KC enthusiastically supports SB 639 and SB 698 as a critical first step in addressing the maternal health crisis that exists in Missouri, particularly for Black mothers. The legislation extends postpartum coverage in Medicaid to one year. Enacting SB 639 and SB 698 recognizes the importance of women’s health outside the narrow window of pregnancy and delivery. The bipartisan support for improving maternal health signals a universal commitment in Missouri to take action against unacceptable rates of maternal morbidity and mortality. This is a health equity issue as Black mothers experience mortality at a rate that is 4 times that of White mothers. Missouri currently ranks 42nd in the nation in maternal mortality. It is estimated that 80% of these deaths are preventable.

At the onset of the pandemic, emergency health measures were taken by the federal government allowing those on Medicaid to continue coverage as a necessary and humane approach to extraordinary circumstances. When the emergency directive expires, Missouri reverts to a 60-day limit on postpartum Medicaid coverage as income eligibility guidelines return to pre-pregnancy levels, potentially leaving many of the mothers we serve without access to health care at a critical time. According to the Commonwealth Fund, over half of maternal deaths occur during the postpartum period. This statistic does not include the much more common occurrence of maternal morbidity which the American College of Obstetricians and Gynecologists (ACOG) asserts happens with 1 in every 173 live births.

Missouri has already taken action in recognizing the importance of maternal health by securing a waiver to extend postpartum coverage to mothers suffering from substance use disorders. Let’s build on that foundation and provide critical health care to an additional 6,200 Missouri mothers.

Thank you to Senator Gannon and Senator Schupp for introducing this legislation and to the committee for your consideration of this important issue.