Last month, the Policy Center for Maternal Mental Health (“Policy Center”) released its second annual report highlighting state efforts to improve maternal mental health outcomes. Over the past few years, maternal mental health has gained momentum at both the federal and state levels. The report evaluates 2024 state legislation introduced on maternal mental health care, a summary of the MMH legislation, tracking of state legislative actions and assesses alignment with the Policy Center’s model legislation.

In 2024, 72 bills were introduced in 20 states, compared to 107 bills in 16 states in 2023. Most bills addressed building awareness of maternal mental health and improved screening. Nine out of 20 states passed MMH-related legislation.

Four states (California, Illinois, Louisiana, and Kentucky) passed substantive laws that met the Policy Center’s model legislation standards. They include:

• California AB 1936 expands on AB 2193 by mandating insurers cover maternal mental health screenings at set intervals with monitoring.
• Illinois S.B. 0647 mandates prenatal providers to screen for maternal mental health disorders.
• Kentucky S.B. 74  establishes the Kentucky Maternal Psychiatry Access Program, also known as the Kentucky Lifeline for Moms, to provide reproductive psychiatry consultation to OB/GYNs and other providers treating the perinatal population.
• Louisiana S.B. 148  requires Insurers to simplify prior authorization and other treatment barriers if no alternative FDA-approved postpartum perinatal depression?  drug exists

In addition to state legislators, state agency leaders have also taken strides to support maternal mental health in Medicaid. All but two states have adopted the postpartum extension for pregnant women, states are rapidly adopting new maternal health services and providers, such as doulas, and helped to boost maternal depression screenings in well-child visits. In the past year, 8 states expanded eligibility for pregnant women in Medicaid. We learned from many colleagues in the field to outline these and other possible Medicaid actions earlier this year State Medicaid Opportunities to Support Mental Health of Mothers and Babies During the 12-Month Postpartum Period.

The attention and energy spent on maternal health and mental health in the last few years has been promising. Yet we know right now Congress is contemplating major cuts to Medicaid in various forms that could shift costs to states. Caps would shift costs to states, forcing the same state leaders who have championed maternal health investments to decide where to make cuts: eligibility, benefits or provider rates?

One in five mothers is impacted by maternal mental health conditions and 75% remain untreated. States have led efforts across public and private insurance to ensure pregnant and postpartum women experiencing maternal mental health conditions receive the care that they deserve in a timely manner. With Medicaid’s critical role as a major payer for births and maternal health, federal cuts could undo the very progress states have made in a short period of time.