Tina Marie Marsden’s son was about four months old when she was diagnosed with postpartum cardiomyopathy.
Two decades later, the Griffin mom now depends on an eight-pound device that keeps her heart pumping. She carries it constantly and everywhere, including into the shower.
If she’d had Medicaid coverage after she gave birth, Marsden says she would have sought medical care sooner. Instead, she’s hoping she can help other mothers access health care coverage following a pregnancy. Cardiomyopathy is a common cause of death in Georgia’s maternal mortality cases.
“Maternal health is extremely important. We are losing too many women,” said Marsden, who is now a patient advocate with the American Heart Association. “Extending this to a year and being able to provide that coverage for women is going to have a great impact not just on that individual, but on that family, which is going to have an impact on that community.”
Georgia routinely falls toward the bottom on national maternal mortality rankings, which has spurred action at the Statehouse in recent years.
In the past, low-income moms were covered for 60 days after their pregnancy ended. In 2019, a legislative panel recommended extending the coverage to one year, but legislators extended it to six months as a compromise, with some GOP leaders wary of the price tag.
Last year’s federal coronavirus relief aid temporarily stretched the coverage out a full year, and now there’s a bipartisan push to make the longer coverage permanent. Gov. Brian Kemp included $28 million in his budget proposal to fund the extension. And Monday, the state Senate unanimously approved the accompanying bill, sending it to the House for consideration.
The governor’s spending proposal also includes $680,000 for an echocardiogram pilot program for women during and after pregnancy.
“Georgia ranks very, very low in the country in that we have more maternal deaths than most other states,” Sen. Dean Burke, a Bainbridge Republican and physician, said at a recent committee meeting. “And the good part is we have recognized that and have put a lot of work into it.”
Black women are at least three times more likely than their white counterparts to die before, during or not long after giving birth. A state review panel deemed the majority of pregnancy-related deaths in Georgia preventable.
And from 2012 to 2014, one third of the pregnancy-related or -associated deaths happened more than six months but less than year later, according to the state’s Maternal Mortality Review Committee report in 2019.
Advocates have long championed extended postpartum Medicaid coverage as a remedy. And Kyesha Lindberg, executive director of Healthy Mothers, Healthy Babies, celebrated the broad support seen now for the full year of coverage.
“I think this pandemic highlighted things that many of us had known, but I think it put it in a light that is uncontentious,” Lindberg said Monday after the Senate vote. “These disparities exist, and we need to prioritize supporting mothers and birth-givers.”
Lindberg, who also sits on the Maternal Mortality Review Committee, said sometimes there is a direct connection between a woman’s pregnancy and her death. A hemorrhage during birth, for example, is cut and dried.
But other times, it is less clear.
For example, a mother may develop a perinatal mood disorder that, if untreated, might drive her to substance use or suicide 10 months after the pregnancy. Or someone could have mild hypertensive disorder that is exacerbated during pregnancy.
A full year of coverage will go a long way toward catching problems that can arise after the pregnancy is over, Lindberg said.
“It’s extremely powerful, particularly because we know that the vast majority of those maternal deaths happen postpartum,” she said. “Almost if not over half of the births in Georgia happen from birth-givers who have Medicaid as their insurance coverage. So, it’s significant in preserving the health and wellbeing of moms and babies across the state.”
Senate Minority Leader Gloria Butler, a Stone Mountain Democrat, said the extended coverage would be a “major stride towards reducing our abysmal maternal mortality rate in Georgia.”
But Butler also took the opportunity to renew the Democrats’ call to fully expand Medicaid. Georgia, which has one of the highest uninsured rates in the country, is one of a dozen states that have not expanded Medicaid under the Affordable Care Act.
“If we pass this legislation to extend Medicaid coverage for new mothers, then we need to look closely at the other things we can do to help people who are struggling with health care. This expansion is crucial, but it is not enough. It will not re-open rural hospitals or make a woman’s drive to see her doctor any shorter,” Butler said.
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