Sb 338: Amendments Relating to Medicaid Postpartum Coverage

• Jurisdiction: Georgia,United States
• Citation: Vol. 39 No. 1
• Publication year: 2022
• topic: Health Law

SB 338: Amendments Relating to Medicaid Postpartum Coverage

Ivona Relja

irelja1@student.gsu.edu

Meredith Elkin

melkin1@student.gsu.edu

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SOCIAL SERVICES

Public Assistance: Amend Article 7 of Chapter 4 of Title 49 of the Official Code of Georgia Annotated, Relating to Medical Assistance Generally, so as to Increase Postpartum Coverage Under Medicaid from Six Months to One Year Following the End of the Pregnancy; Provide for Related Matters; Repeal Conflicting Laws; and for Other Purposes

Code Section: O.C.G.A. § 49-4-159 (amended)

Bill Number: SB 338

Act Number: 870

Georgia Laws: 2022 Ga. Laws 759

Effective Date: July 1, 2022

Summary: This Act amends Medicaid postpartum coverage for mothers from a period of six months to one year. The Department of Human Services will provide postpartum care Medicaid coverage to mothers for a period of one year following the date pregnancy ends.

History

Maternal health coverage remains a hot topic as states continue to enact laws promoting the closure of Medicaid coverage gaps.¹ Because Medicaid provides coverage for almost half of all births nationwide, it plays a significant role in supporting the health of new mothers and their babies.² For years, maternal mortality rates in the United States have significantly increased for all races and age groups; however,

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states that have expanded Medicaid have shown a decrease in maternal mortality compared to non-expansion states.³

Where does the State of Georgia weigh in? Georgia has one of the highest rates of maternal and infant mortality.⁴ To address this, the Georgia General Assembly passed Senate Bill (SB) 273 during the 2014 Legislative Session.⁵ SB 273 established the Georgia Maternal Mortality Review Committee (MMRC) to "identify the causes and potential solutions to Georgia's high maternal mortality rates" and develop reports analyzing maternal death cases.⁶ After reviewing approximately 250 maternal deaths between 2012 and 2014, the MMRC found that approximately 101 of the 250 maternal deaths were pregnancy-related.⁷ The 2014 Georgia Maternal Mortality Report further noted that 55% of pregnancy-related deaths occurred within forty-two days postpartum.⁸ African American women accounted for the majority of these pregnancy-related deaths.⁹ Data suggested approximately 60% of the pregnancy-related deaths were preventable.¹⁰

As a result of the MMRC's findings, the Georgia House of Representatives passed House Resolution (HR) 589 during the 2019 Legislative Session.¹¹ HR 589 created the House Study Committee on Maternal Mortality (the Committee).¹² Acknowledging maternal

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deaths as "a serious public health concern" with "tremendous family and societal impact, affecting diverse populations," the Committee sought to develop strategies to decrease maternal deaths in Georgia.¹³ The Committee found that the "leading causes of pregnancy-related deaths in Georgia . . . were cardiomyopathy, hemorrhage, cardiovascular and coronary conditions, embolism, preeclampsia and eclampsia, and amniotic fluid embolism."¹⁴ Following review and testimony by university-based programs and providers, the Committee made numerous recommendations, including to "[e]xtend Georgia's Medicaid coverage for eligible pregnant women to one-year postpartum to allow for continued access to health care services."¹⁵

Medicaid and Mothers

Medicaid provides mothers and children with numerous medical care benefits, including immunizations and health check-ups, prescription medications, and dental and vision care.¹⁶ Although federal law requires certain Medicaid benefits, "[s]tates establish and administer their own Medicaid programs and determine the type, amount, duration, and scope of services within broad federal guidelines."¹⁷ Because most maternal deaths occur postpartum, extending Medicaid coverage to one year post-pregnancy provides uninsured, low-income mothers with resources and benefits to ensure they remain healthy.¹⁸

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Gradual Changes

In 2021, Congress passed House Resolution 1319, the American Rescue Plan Act (the Plan).¹⁹ The Plan implemented numerous changes and sought to provide millions of individuals with economic relief by allocating over $1 trillion to various programs.²⁰ Of note, the Plan provided states with the option "to extend Medicaid coverage up to one year postpartum through a state plan amendment."²¹ In 2021, Georgia received federal approval for its request to extend coverage through six months postpartum, an improvement over Georgia's previous Medicaid coverage for new mothers which lasted sixty days.²²

Soon after Georgia received federal approval to extend coverage to six months postpartum, a new bill began moving through the Georgia legislature to extend the approved six months of coverage to twelve months postpartum.²³ SB 338 passed with support from Governor Brian Kemp (R) and the Georgia Department of Community Health,

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paving the way for possible improvements to Georgia's maternal health outcomes.²⁴

Bill Tracking of SB 338

Consideration and Passage by the Senate

Senator Dean Burke (R-11th), a practicing obstetrician and gynecologist, authored SB 3 3 8.²⁵ Twenty-five Senators, Democrats and Republicans, signed onto SB 338 as co-sponsors.²⁶ The Senate read SB 338 for the first time on January 24, 2022, and referred the bill to the Senate Committee on Health and Human Services on the same day.²⁷ On February 2, 2022, the Senate Committee favorably reported on the bill by substitute.²⁸ The substitute removed the language marking the beginning of the postpartum care coverage period as the date "the woman gives birth."²⁹ Instead, the substitute uses the date that "the pregnancy ends" to mark the beginning of the coverage period.³⁰ The Senate read SB 338 for the second time on February 3, 2022, and for a third time on February 7, 2022.³¹ The Senate passed

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SB 338 by a vote of 54 to 0 on February 7, 2022, ensuring that the legislation traveled to the House well before Crossover Day.³²

Consideration and Passage by the House of Representatives

Representative Sharon Cooper (R-43rd), Chairman of the House Health and Human Services Committee, sponsored SB 338 in the House.³³ The House first read the bill on February 8, 2022, and again on February 10, 2022.³⁴ Although the House Committee favorably reported on the bill on March 23, 2022, SB 338 was withdrawn and recommitted two days later on March 25, 2022.³⁵ On April 4, 2022, the House Committee once again favorably reported on the bill, and the House read SB 338 for the third time.³⁶

Final Passage and the Governor's Signature

On April 4, 2022, the House passed SB 338 and adopted the bill by a vote of 142 to 18.³⁷ The Senate sent SB 338 to the Governor on April 7, 2022.³⁸ Governor Kemp signed SB 338, now Act 870, on May 13, 2022.³⁹ The Act's effective date is July 1, 2022.⁴⁰

The Act

The Act amends Article 7 of Chapter 4 of Title 49 of the Official Code of Georgia Annotated, relating to medical assistance generally.⁴¹ The overall purpose of the Act is to increase postpartum coverage under Medicaid from six months to one year.⁴²

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Section 1

Section 1 of the Act revises paragraph (2) of subsection (a) of Code section 49-4-159, which relates to Medicaid coverage for postpartum care for mothers.⁴³ The Act increases Medicaid coverage for postpartum care from six months to one year.⁴⁴ Further, the Act changes the event that triggers postpartum coverage.⁴⁵ Originally, the language read that postpartum coverage was triggered "following the date...