Mississippi is a state with a dual distinction when it comes to reproductive health care. The law was enacted by the state, and will likely be struck down by the Supreme Court. Roe v. Wade. It is also the only state in the Deep South that does not provide health care coverage for low-income women who have given birth.
Mississippians who are eligible for Medicaid, the government’s health insurance program for the poor lose coverage within 60 days of childbirth. That’s often well before the onset of postpartum depression or life-threatening, birth-related infections: A 2020 study The study found that women spent 81% on postpartum costs between 60 days and one year after delivery. And Mississippi’s own Maternal Mortality Review Committee Researchers found that 37% died from pregnancy-related causes between 2013 & 2016. These deaths were more than six weeks after the birth.
Every other state In the Deep South, Medicaid coverage has been extended to 12 months postpartum or is being extended. Wyoming and South Dakota are two other states where trigger laws will prohibit nearly all abortions. Roe falls and where lawmakers haven’t expanded Medicaid or extended postpartum coverage.
“It’s hypocrisy to say that we are pro-life on one end, that we want to protect the baby, but yet you don’t want to pass this kind of legislation that will protect that mom who has to bear the responsibility of that child,” said Cassandra Welchlin, executive director of the MS Black Women’s Roundtable, a nonprofit that works at the intersection of race, gender and economic justice.
Efforts To extend coverage beyond 60 Days repeatedly failed in Mississippi — where 60% of births are covered by Medicaid — despite support From major medical associations legislators On both sides The aisle.
Mississippi House Speaker Philip Gunn, a Republican, said shortly after he killed the most recent bill that would’ve extended postpartum coverage that he’s against expanding Any form of Medicaid. “We need to look for ways to keep people off, not put them on,” he told The Associated PressIn March. In an interview with the May 8th edition of The Guardian, the issue was brought up. CNNMississippi Gov. Tate Reeves said, “When you talk about these young ladies, the best thing we can do for them is to provide and improve educational opportunities for them.” (Neither Gunn nor Reeves responded to requests for comment.)
A federal rule change prevented states from cutting off Medicaid recipients during the pandemic. This has allowed people in Mississippi and other states to continue their postpartum coverage beyond 60-days. But at the end of the federal public health emergency declaration — which is set to expire in July 2022 — states will revert to their prior policies. “What we are afraid of is that when that does end, it will go back to what we knew was pre-pandemic health care,” Welchlin said.
We discussed the implications of Mississippi’s post-Roe reality with Welchlin and two other experts in the field: Alina Salganicoff, the Kaiser Family Foundation’s director for women’s health policy, and Andrea Miller, president of the National Institute for Reproductive Health. The answers were lightly edited to ensure clarity and length.
What services does Medicaid offer postpartum?
Alina Salganicoff: This includes anything from support if the person has problems breastfeeding to screening services for depression.
Cassandra Welchlin: We are all familiar with the struggles of those who have been diagnosed with life-threatening illnesses like hypertension or heart conditions. We also know Medicaid is available to help.
What are your observations on Mississippi’s postpartum needs?
Welchlin: One of the stories I was most touched by during the pandemic was about a mom who had already given birth to a child and needed child care so that she could return to the doctor. During this particular pregnancy she had a severe heart disorder where she couldn’t breathe, and she had to get rushed to the hospital. Because she was so connected to doulas and a supportive care organization like us, she was able to get admitted and sure enough that’s when they diagnosed her with that heart condition. She was also a mother on Medicaid.
What happens to mothers who lose Medicaid coverage after having a baby?
Andrea Miller: Only giving someone two months postpartum doesn’t allow for the kind of continuation of care that you need. If there are indications of problems in the postpartum period, they don’t all necessarily show up within the first two months. We know that coverage is a key factor in the ability to have a healthy baby and keep it healthy. This type of care is possible with the extension to 12 month.
Welchlin: We know in the state of Mississippi, women die at higher rates, and of course it’s higher for Black women. And so, when women don’t have that coverage, what happens is they die.
What does it mean not to extend postpartum Medicaid coverage? Roe falls?
Miller: These bans on abortion are going to be layered on top of an already-unconscionable maternal and infant health crisis that most particularly impacts those who are struggling to make ends meet. It particularly impacts Black women and other communities of color…. A state like Mississippi that is so clearly wanting to ban abortions — the fact that they refuse to extend basic health care benefits that will help during pregnancy and postpartum just clearly indicates that they are not interested in the health and well-being of women and families and children, that they are purely on an ideological crusade.
Any other suggestions?
Salganicoff: We’re very focused on that first year of life. But if you’re speaking about a woman who is not going to be able to get an abortion that she seeks and ends up carrying the pregnancy, the supports that she’s going to need and her child is going to need go far beyond the first year of life.
Miller: You can’t have a conversation about legality or soon-to-be illegality of abortion in these states and not have a conversation simultaneously about the existing crisis around maternal and infant health. These things are all interconnected, and that’s why it is so deeply disturbing that the states trying to ban abortion are the same states that are refusing to expand Medicaid under the ACA, that are failing to take advantage of the ability to extend postpartum [coverage] by 12 months, that don’t invest in child care, that don’t invest in education — these are all part of the same conversation.
Welchlin: Audre Lorde said, “There is no such thing as a single-issue struggle because we do not live single-issue lives.” So, abortion access, reproductive justice, voting rights, racial justice, gender equity — these are not separate issues, they are intersecting issues that collectively determine the quality of our lives.
