More women in Alaska are now eligible for Medicaid coverage during pregnancy and after giving birth. And eligible mothers will be covered for a full year after giving birth, instead of just two months.
Medicaid is free health insurance for low-income people in the United States and about a third of Alaskans are covered by it. The income cutoff for pregnant women and for children is higher than for individuals.
Jennifer Heller, a nurse midwife for Alaska’s Division of Public Health, said the Medicaid expansion is important because almost three-quarters of maternal deaths in the state happen in the year after giving birth.
“I think it’s going to make a really big difference in the lives of families and Alaska,” Heller said. “And, one thing to remember is that infants are covered up to one year after birth; they have that extended eligibility. And so, this is really just matching for maternal coverage, what infants get, which is really, really important.”
Heller said in the year after birth mothers may be dealing with big health issues like cardiovascular problems, high blood pressure and gestational diabetes. She adds that the first year can be a difficult time mentally.
Mothers with postpartum depression will now be better covered by Medicaid, Heller said. Postpartum depression is caused or made worse by shifts in hormones after giving birth and about one in seven mothers experience it. Many are undiagnosed, sometimes because they don’t want to tell their family. And Heller said the mental health of the mother affects the infant.
“When a mom is struggling with a postpartum mood disorder, it does affect the baby’s development, we know that,” Heller said. “And, if your medical coverage is six weeks, that might be just when you’re realizing, ‘Oh, this is really affecting me. I’m not doing okay, I’m not getting better.’”
Only about two-thirds of Alaskans get adequate health care during pregnancy. The Division of Public Health doesn’t know exactly how many more women will be covered during pregnancy with the new changes, but they say thousands more Alaskan mothers will qualify. Now women at 225% of the federal poverty level qualify for Medicaid, up from 200%. That means the income cutoff for this year for an individual would be $42,322.
Heller also said that many women are motivated to reduce or stop drug use during pregnancy, but the postpartum period can be very stressful so it’s important for women to have health care during that time.
“We know that relapse is a big issue in the postpartum period,” Heller said. “And then relapse in the postpartum period has a huge risk of overdose death, because your body chemistry has changed and you haven’t been using those substances. So that is a very high risk issue in the postpartum period.”
The expansion of Medicaid coverage was implemented because of state Senate Bill 58. It was signed into law by Gov. Mike Dunleavy in May 2023.
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Rachel Cassandra covers health and wellness for Alaska Public Media. Reach her atrcassandra@alaskapublic.org. Read more about Rachel here.