Pritzker Administration Announces Illinois is First State to Extend Full Medicaid Benefits to Mothers 12 Months Postpartum

Continuous Coverage Will Help Ensure New Mothers Don’t Go Uninsured During the Critical Postpartum Period; Extension to Help Address the Maternal Morbidity and Mortality Rate

Governor Pritzker today announced Illinois is the first state in the nation to extend full Medicaid benefits from 60 days to 12 months postpartum, following the federal Centers for Medicare & Medicaid Services (CMS) approval of Illinois’ 1115 waiver allowing for the extension. The extension of Medicaid postpartum benefits to 12 months will strengthen continuity of care to improve health outcomes for new mothers in Illinois and is aimed at reducing the rate of maternal morbidity and mortality, including significant health disparities for Black women during the postpartum period.

“Every mother in Illinois deserves access to quality healthcare following the birth of a child, regardless of their income level,” said Governor JB Pritzker. “I’m proud to announce Illinois is now the first state in the nation to offer eligible mothers 12 months of postpartum care coverage through Medicaid. This coverage expansion will further my administration’s work to reduce health disparities in communities across the state and improve maternal health outcomes for women of color.”

Women with incomes up to 208% of the federal poverty level will have continuous Medicaid eligibility through 12 months postpartum, a significant increase in coverage from the standard 60-day postpartum period.

“This enhanced period of care for Illinois mothers is vital for them, their babies and their families, and is critical to reducing maternal morbidity and mortality rates and the alarming disparities in health outcomes for Black women and all women with Medicaid coverage across the state,” said Illinois Department of Healthcare and Family Services Director Theresa Eagleson. “We thank our federal partners for recognizing this great need and approving Illinois’ long-standing request.  We also thank partners in the advocacy and legislative communities who have championed women’s healthcare right alongside us.  Healthy moms equate to healthy babies and families and we are so grateful for this approval.”

Current Medicaid postpartum coverage is 60 days for women with incomes up to 208% of the federal poverty level (FPL). Beyond that point, women can continue coverage with incomes up to 138% FPL. Without this newly approved 1115 waiver, women between 139-208% FPL would be left uncovered in the event they develop a serious pregnancy-related illness beyond the 60-day postpartum timeframe and haven’t enrolled in new coverage yet.  For women who have enrolled in new coverage, they may have to find new in-network doctors who are not familiar with their medical history during a vulnerable time.

“We know that a significant share of pregnancy-associated deaths are preventable, and in 2021, mothers should absolutely not be dying from preventable causes after they give birth,” said State Sen. Cristina Castro (D-Elgin). “Extending Medicaid benefits to mothers for 12 months postpartum is a critical step toward reducing the maternal morbidity and mortality rate.”

Research shows that disruptions in Medicaid coverage are common and often lead to periods of lack of insurance, delayed care, and less preventive care for beneficiaries. For women who have enrolled in new coverage, they may have to find new in-network doctors who are not familiar with their medical history during a medically vulnerable time.

“Providing Medicaid benefits to mothers for 12 months postpartum is vital to ensuring women have the care they need not just during pregnancy, but after,” said State Rep. Robyn Gabel (D-Chicago). “Illinois continues to be a leader in women’s healthcare, and I’m grateful to our federal partners for their approval of this waiver.”

The continuity of coverage available through this waiver approval will help mothers manage chronic conditions like hypertension and diabetes and provide important access to behavioral health and other mental health care services.

“The maternal morbidity and mortality rate in Illinois remains far too high. In particular, Black mothers are six times more likely to die from pregnancy related issues than white mothers, which is unacceptable,” said State Sen. Mattie Hunter (D-Chicago). “More than 70 percent of these kinds of deaths could have been prevented, which is why I applaud the Centers for Medicare & Medicaid Services for approving Illinois’ waiver allowing for this critical coverage. With this initiative, mothers will be given for up to 12 months postpartum, which could be lifesaving to many.”

An October 2018 Illinois Maternal Morbidity and Mortality Report, developed by the Illinois Department of Public Health (IDPH), recommended extending continuous coverage to women for 12 months postpartum.  The report found that Non-Hispanic Black women are six times as likely to die of a pregnancy-related condition as non-Hispanic white women. IDPH also found that poor continuity of care and a lack of care coordination are factors contributing to death in 93% of preventable pregnancy-related deaths during the late postpartum period (61-364 days postpartum).  In 2019, Gov. Pritzker signed a bill into law making the change from 60 days to 12 months, and the state formally applied for the waiver from federal CMS later that year.