MONTGOMERY – Alabama’s new extension of postpartum Medicaid coverage will reduce maternal mortality and improve health for families across the state. This policy change will result from the fiscal year 2023 General Fund budget that Gov. Kay Ivey signed into law April 7. The budget includes $8.5 million to bolster postpartum care and reduce maternal mortality rates.
These funds will extend Medicaid coverage for new mothers in Alabama, providing them access to life-saving health care for 12 months post-delivery. Mothers on Alabama Medicaid now lose their coverage and access to care just 60 days after childbirth.
Alabama has the nation’s third-worst maternal death rate. Each year, nearly 40 new mothers in the state die within one year after delivery. The toll on Black mothers is nearly three times that of white moms.
The Cover Alabama Coalition commends Ivey, the Alabama Legislature and the Alabama Medicaid Agency for including funding to extend postpartum Medicaid coverage in the General Fund budget. The American Rescue Plan Act (ARPA) gave states an incentive to increase Medicaid coverage from 60 days to 12 months via a state plan amendment. Cover Alabama plans to continue to work with the governor’s administration to ensure this program is sustainable and permanent.
Research shows that outcomes improve when moms have access to high-quality, equitable and uninterrupted care. Extending the Medicaid postpartum coverage period is a big step to save lives and improve the health and well-being of families, communities and the entire state.
More than 20 Cover Alabama partners released statements in support of the postpartum Medicaid extension provision recently signed into law. They are available in their entirety below.
Robyn Hyden, Executive Director, Alabama Arise:
“Extending Medicaid coverage from the current 60 days to one year after childbirth will save and improve lives across Alabama. It will help reduce long-standing racial disparities in health care that have plagued our state for generations. It also will promote more stable families, vibrant communities and a healthier future. This is an important step closer to the day when all Alabamians can get the health care they need to survive and thrive. Alabama Arise applauds Governor Ivey and the Legislature for including these provisions in the General Fund budget. And we urge Alabama Medicaid to act immediately to submit a state plan amendment to extend this coverage.”
Dr. Julia Boothe, President, Medical Association of the State of Alabama:
“The Medical Association of the State of Alabama commends Governor Ivey for including in her budget the extension of postpartum coverage for women who depend on Medicaid for their pregnancy deliveries. Most pregnancy-related health concerns can continue up to a year after birth, and 70% of the deaths reviewed by the Maternal Mortality Review Committee (MMRC) were preventable. The MMRC also found that cardiovascular risk factors and mental health and substance abuse disorders were the leading underlying causes of pregnancy-related deaths in Alabama. Moreover, women of color are disproportionately affected. As we strive to expand access to care in Alabama and in its most rural areas, this extension will provide women on Medicaid needed treatment and resources before, during and after pregnancies. For the 30,000 Alabamians whose deliveries are covered by Medicaid each year, extending coverage can be life-saving for not only the mother, but also the child. Physicians statewide believe that this is a positive step in the right direction for Alabama in reversing the dangerous trend in maternal deaths and continuing access to care for mothers after pregnancy.”
Jada Shaffer, Government Relations Regional Director, American Heart Association:
“Heart disease and stroke contribute to approximately one in three of these deaths, elevating the importance of early interventions that improve maternal health for all mothers. Therefore, we are grateful for the bipartisan support of the Alabama Legislature and Governor Kay Ivey to include funding to increase postpartum care for mothers from 60 days to 365 days. However, it is imperative we continue to work with the Legislature and the administration to ensure this program is sustainable. We believe that there are opportunities to take full advantage of the ARPA incentive to extend this life-saving coverage for the full five years via state plan amendment.”
Rachel Bunning, Vice President, External Affairs, Women’s Foundation of Alabama:
“Women’s Foundation of Alabama applauds Governor Ivey and the Alabama Legislature for providing the funding necessary to extend postpartum coverage for women from 60 days to a full year. 30,000 Alabama moms now have access to necessary follow-up care, a crucial step toward addressing Alabama’s maternal death rate. This crucial first step toward expanded coverage not only benefits women and their children but entire communities, because we know when women succeed, families thrive, and communities grow.”
Katrina Skinner, M.D., FAAP, President, Alabama Chapter – American Academy of Pediatrics:
“The Alabama Chapter-AAP applauds the state for budgeting additional dollars to extend Medicaid postpartum coverage from the current standard of 60 days to 12 months, as this is key to improving maternal health and addressing disparities in outcomes in Alabama. Evidence also shows that continuing Medicaid coverage for postpartum mothers also improves health outcomes for children. This could not be more important in Alabama, which has an infant mortality rate of 7.0 deaths before age 1 per 1,000 live births, compared to a national rate of 5.5. Of note, 65% of these infants were covered by Medicaid, compared to 50% Medicaid coverage for all live births.”
Vikas Gupta, M.D., MPH, President, Alabama Academy of Family Physicians:
“The Alabama Academy of Family Physicians is grateful to Governor Ivey for allocating dollars to extend postpartum coverage for women on Medicaid from 60 days to one year. This will truly impact the health and well-being of mothers and babies in Alabama. Currently, Alabama has an infant mortality rate of 7.0 deaths before age 1 per 1,000 live births. This extension brings us one step to closing the gaps in coverage and will begin to turn the tide of negative outcomes for this vulnerable population.”
Julie Vojtech, Government Relations Director, American Cancer Society Cancer Action Network:
“Research shows that uninsured Americans are less likely to get screened for cancer and thus are more likely to have their cancer diagnosed at an advanced stage when survival is less likely and the cost of care more expensive. ACS CAN supports extending affordable, quality insurance coverage to more Alabamians to help ensure they have access to the care they need, including preventive services and cancer screenings that can be life-saving and improve the lives and health of their families.”
Holly Caraway McCorkle, Executive Director, Alabama Council for Behavioral Healthcare:
“Mental health and substance use disorders were identified as key contributors in almost half of pregnancy-associated and pregnancy-related deaths in the state of Alabama. In addition, postpartum depression and anxiety disorders affect one in seven mothers nationwide, making it the most common complication of pregnancy and childbirth. Therefore, we applaud any effort to extend postpartum Medicaid coverage, so that Alabama’s new mothers are receiving regular care for their critical mental and physical health needs.”
Ashley Lyerly, MPA, Senior Advocacy Director, American Lung Association in Alabama:
“Improving postpartum coverage from 60 days to 12 months is an important component of reducing maternal mortality and health disparities in Alabama. The American Lung Association applauds Governor Ivey and the Alabama Legislature for including funding to extend postpartum coverage to one year in the FY 23 General Fund budget. We urge Alabama Medicaid to promptly submit a state plan amendment to the Centers for Medicare and Medicaid Services. We look forward to working with Governor Ivey, the Legislature and Alabama Medicaid to ensure implementation and long-term success of improving access to care for postpartum women.”
Matthew Richardson, Government Affairs Manager, Nurse-Family Partnership:
“Nurse-Family Partnership (NFP) appreciates Governor Ivey and the Alabama Legislature’s efforts to include funding in the budget to extend Medicaid coverage for new mothers. As an evidence-based, community health program focused on improving the health and lives of first-time moms and their babies, NFP knows how important health insurance coverage is. Coverage can ensure access to critical health care services, especially during the important perinatal period. Extending pregnancy-related coverage to 12 months after delivery will reduce maternal mortality and morbidity, eliminate health disparities and advance health equity. Thank you for prioritizing the health and well-being of Alabama moms!”
Collier Tynes, CEO, VOICES for Alabama’s Children:
“VOICES for Alabama’s Children applauds Alabama lawmakers for this monumental win for children and families. According to the 2021 Alabama Kids Count Data Book, Alabama is ranked No. 47 in children’s health. One of the most important ways we can change this number is to support infant and maternal health as a hand-in-hand relationship. When a new mom is without physical and mental health care, it is detrimental to the baby’s health and brain development during the most formative years of life. The extension of postpartum health care coverage is a tremendous step toward an Alabama where every child and family is happy, healthy and wildly successful.”
Dalia Abrams, Executive Director of Program Operations, BirthWell Partners Community Doula Project:
“BirthWell Partners applauds Governor Ivey and our state Legislature for extending health care coverage through Medicaid for the first year after birth. Our doula program supports these families during pregnancy, labor, birth and the early postpartum period. We see firsthand the importance of continued medical coverage for the health of mothers, and by extension, for the health of their babies. This major step toward equity will play a big part in addressing disparities in maternal and infant health outcomes. Families of Alabama thank you!”
Katie Jeter, Executive Director, Children First:
“Children First could not be more appreciative to Governor Ivey, our Alabama Legislature and this entire coalition for the efforts made to make Alabama mothers, babies and families a priority, by expanding Medicaid coverage to postpartum mothers. It is vital that we continue to make these huge steps of progress, so that Alabama can be a safe place to raise a family. We are very excited to see how these beginning steps of Medicaid expansion will continue to grow for years to come. Thank you for protecting Alabama’s smallest citizens, by making sure their mothers are receiving the help, support and treatment they need and deserve.”
Ashley Tarrant, Interim CEO, Medical Advocacy & Outreach:
“Medical Advocacy & Outreach commends Governor Ivey and the bipartisan group of legislators who secured funding to extend postpartum Medicaid coverage from 60 days to a full year. This policy shift will save the lives of countless mothers who will, in turn, give their precious babies the best possible start in life. Our providers see firsthand the challenges that new mothers face, and we recognize the grave risks of having their insurance abruptly end during such a crucial time of healing. In my own work as a doula supporting women through pregnancy and the postpartum period, I have personally seen the importance of seamless health coverage and the critical health care access it provides – and now, I am personally excited to see how this extension will change women’s lives.”
Mary Spears, Communications, United Women of Color (UWOC):
“United Women of Color appreciates that the state Legislature and Governor Ivey saw fit to value women by providing funds that allow for the extension of postpartum care. Alabama has one of the highest rates of maternal death in the nation. We hope that this is the first step of many to ensure that mothers who bear children and are eligible for SOBRA Medicaid have access to affordable, reliable health care. During the first year of their newborn child’s life, bonding and infant brain development should be top concerns for mothers, not worrying about health care needs.”
Lindsey Harris, DNP, FNP-BC, President Alabama State Nurses Association:
“Being on the front lines of health care, the state nurses commend Governor Ivey and the state Legislature for extending postpartum maternal health coverage for women for 12 months post-delivery. Alabama nurses have experienced mothers who once the coverage ends have neglected to seek care for themselves as the focus shifts to caring for the infant and not themselves as now they must pay for health care needs out of pocket. This expansion of coverage will allow mothers to remain in the care of the maternal health care provider to ensure optimal wellness.”
Dr. A.B. Sutton, Jr., Chairman of Faith in Action Alabama and Pastor of Living Stones Temple:
“Faith in Action Alabama applauds Governor Ivey and our state Legislature for taking the important life-affirming step to extend postpartum Medicaid coverage to one year. This policy will significantly improve health care services for economically disadvantaged Alabamian mothers and their infants. This decision honors the imperative of celebrating and protecting all of God’s children, across race and income lines.”
Tiffany H. Taft, Ph.D., Chief Wellness Officer/Executive Director, Sacred Soul Wellness LLC:
“‘…Let them be born, and handled warmly…’ Sacred Soul Wellness is committed to the empowerment, advocacy and reproductive health of ALL mothers, but especially to BIPOC mothers of Alabama who often are without proper means or access to care. We stand in need of support, access and legislative provisions that are more than just about what’s medically necessary but what is also morally right. Access to care and services should be available to all in a movement toward preventative/well care and not costly medical care and interventions that may arise or be worsened by lack of access. We look forward to working with Alabama’s leadership, medical officers/physicians, midwives and the Alabama Legislature for this policy shift that will literally save more lives and allow mothers and families the time they truly need to heal well, fully, and whole of their mind, body and spirit. This funding and extension of postpartum coverage to one year is a much needed step to keeping Alabama families WHOLE and is important to preserving the best possible long-term outcomes while improving the overall current maternal mortality crisis faced in the state. This intentional strategy is a positive first step that we look forward to supporting and working with key proponents to ensure implementation and long-term success of improving access to care for postpartum women. Thank you for this huge next step!”
The Rev. Julie Conrady, M.Div., Settled Minister, Unitarian Universalist Church of Birmingham:
“Supporting new mothers and babies is the right step at reducing maternal mortality rates and improving the quality of life of all Alabamians, especially communities who have been marginalized. We as people of faith and no faith should be joined together in promoting positive outcomes for women’s health care, and this legislation is a welcome step forward.”
Cortney Brown, Organizer, Alabama Solutions, a grassroots movement:
“Thank you for thinking of our mothers! This is such a great gift to give to mothers all across our state that give so much to us. Thanks to everyone involved in this effort. Currently, for a single mother of three to have a living wage, it would mean she would have to make $43.89 an hour, working full time eight hours a day, five days a week across our state. At Alabama Solutions, we believe that in order to resolve a problem, we need to stick to the facts. We listen to our own experiences as well as look at the evidence. Moving away from those critical thinking skills has created nonsense dialogue and nonsense lawmaking with it. Let’s all stick to the facts here so we can continue to help our state’s people just as we have here with extending postpartum support for our mothers. Thank you again!”
Lenice C. Emanuel, MLA, Executive Director, Alabama Institute for Social Justice:
“Alabama Institute for Social Justice is pleased to see this long overdue expansion of Medicaid coverage for new mothers. Women in Alabama have some of the poorest health care outcomes in the nation, and our maternal mortality rate is double the national rate. Black women are three times more likely to die from a pregnancy-related cause than white women, a disparity that persists regardless of age, education level or where they live. This policy change will provide critical health care access for Alabama’s new mothers, but we must make sure this is not merely a Band-Aid on the gaping wound of health disparities and maternal outcomes in Alabama. It is vital that we both permanently fund this expansion and address continued barriers to health care access, racial and ethnic disparities, and social determinants of health for Alabama’s women and families.”
Alison Smith/Michelle Lax, Co-Presidents; Caroline Smith-Pernell/Mary Lynn Bates, Advocacy, Zonta Club of Birmingham:
“As an organization focused on the well-being of women, Zonta Club of Birmingham is deeply concerned about the lack of access to adequate, affordable health care for far too many Alabama women and tragic health outcomes such as Alabama’s high maternal mortality rate. We commend the Legislature and Governor Ivey for the inclusion in the General Fund budget of funding to extend postpartum Medicaid coverage from two months to 12 months and urge the amendment of Alabama’s Medicaid plan to include 12 months of postpartum coverage going forward. Zonta continues to strongly support the immediate further expansion of Medicaid, which can have a profound impact on Alabama’s families and economy. The extension of coverage for new mothers is an important first step toward a healthier Alabama.”
Swapna Kakani, Director, Alabama Rare:
“Alabama Rare thanks Governor Ivey and our state Legislature for extending postpartum maternal coverage to 12 months. Unfortunately, many rare diseases result in premature deaths of infants and young children, or are fatal in early childhood. Alabama Rare views progress in maternal health as also progress in infant and child health. Families affected by rare diseases after birth often have to focus on their child’s clinical diagnosis, treatment and therapies, not worry about a mother’s postpartum Medicaid coverage. Now families do not also have to sacrifice themselves to care for their child. We see this coverage extension as the groundwork for future investments in our mothers, infants, children and the state’s entire Medicaid population’s health!”
Ana Delia Espino, Executive Director, Alabama Coalition for Immigrant Justice:
“The Alabama Coalition for Immigrant Justice applauds the extension of postpartum health care coverage for 12 months after delivery. This policy is essential for the overall wellness for families in Alabama. This is the right step to improve the quality of life for women and children in marginalized communities.”
Kathy Jones, President, League of Women Voters of Alabama:
“The League of Women Voters of Alabama applauds Governor Ivey and our state Legislature for extending postpartum maternal health coverage to Alabama women for the first 12 months after delivery! Sadly, Alabama has long had one of the highest maternal death rates in the nation. It is anticipated that Alabama will become a safer and healthier place to live as low-income new mothers gain access to longer-term health services. We hope the governor will take the next logical step of expanding Medicaid coverage for a better Alabama.”
Media Release/Jane Adams
Campaign Director | Cover Alabama Coalition
