New Report Outlines Opportunities for States to Leverage Medicaid to Improve Mental Health of Postpartum Moms and Babies

By: Anne Dwyer, Elisabeth Burak, Tanesha Mondestin, and Kay Johnson

As we recognize Maternal Health Awareness Day, it’s a good time to take stock of where the U.S. stands in advancing maternal and child health. The relatively new state option to extend Medicaid postpartum coverage from 60 days to one full year provides states with an important opportunity to ensure the extended coverage period works as intended for postpartum moms and their infants. Mental health is a vital part of each mother’s overall health as well as their child’s health and development. States can leverage Medicaid to ensure that mothers and their infants get the right care at the right time during a sensitive period of family change, maternal health, and early childhood development. This is especially important as untreated perinatal mental health challenges are among the leading causes and drivers of the U.S. maternal mortality crisis – disproportionately affecting Black and Indigenous mothers – and associated with delays in cognitive and social-emotional development for children as early as the first year of life.

Medicaid has a timely and vital role to play as the predominant payer of U.S. births and coverage source for low-income infants. Medicaid finances approximately 40% of births. Notably, national birth data from the Centers for Disease Control and Prevention show that more than two-thirds (64%) of Black mothers and more than half (58%) of Hispanic mothers had Medicaid coverage reported on birth certificates in 2021. This means that Medicaid plays a particularly important role in reducing disparities in maternal and infant health outcomes.

With generous support from the Perigee Fund, the Georgetown Center for Children and Families convened a group of maternal and child health practitioners and Medicaid policy experts to help us generate actionable steps states could take to support mental health for moms and babies during the postpartum year. We were honored to learn from some of the country’s leading experts with a passion for improving maternal and child health and closing persistent health inequities based on race and ethnicity. Today, we are pleased to share the final report from this convening in October 2023. Beginning with context on recent federal actions with implications for state work, the report makes recommendations for state Medicaid leaders, accompanied by detailed action steps, including:

  1. Enhancing Primary Care to Serve More Effectively as a Care Hub for Families
  2. Monitoring and Rewarding Successful Connections to Timely Care
  3. Financing and Removing Barriers to Appropriate Services
  4. Supporting Expanded Workforce Capacity
  5. Prioritizing Maternal Mental Health and Infant-Early Childhood Mental Health in Medicaid

Taken together, these recommendations hold the potential to accelerate use of best practices, advance equity, improve health outcomes for all Medicaid financed births, and ensure the extended postpartum coverage period works as intended to improve the health and mental health of mothers and babies.

Thanks to the many experts who lent their valuable time and experience to this important work. We hope that this report and its recommendations will be a useful tool for states seeking to address the mental health of moms and babies– now is the time to act.

The full report can be found here. 

Note: With focus nationally and in states on “maternal” health, we use the term “mother” to distinguish covered individuals following their pregnancy. We aim to use more inclusive terms when able in recognition that not all individuals who become pregnant and give birth identify as women. Georgetown CCF also uses the term “women” when referencing statute, regulations, research, or other data sources that use the term “women” to define or count people who are pregnant or give birth.