The 12 Days of Ups and Downs of Medicaid Postpartum Extension

The struggle for the extension of Medicaid services for mothers from 60 days to 12 months continues to be a top priority for MSMA. We have all heard the reasons for supporting this bill over the years and continue to see Mississippi lead the nation in infant mortality, preterm birth rate, and pregnancy related mortality. Mississippi is 1 of 2 states without Medicaid expansion and Postpartum coverage up to 12 months. Not only does the extension make economic sense to prevent complications and improve maternal health, it is also the right thing to do in a post-Dobbs decision environment.

The bill has passed the Senate with the full support of Lieutenant Governor Hoseman for 3 years. This session, the bill from the Senate quickly passed again and moved to the House of Representatives to the Medicaid committee.

At the beginning of this year’s session, the bill was championed in the House of Representatives by Representative Missy Magee, R-Hattiesburg, but it never made it out of the House Medicaid Committee. Speaker of the House, Phillip Gunn, has been on record that he did not support the extension and did not support the plan to bring the House bill out from the committee.

Then the roller coaster began. Thanks to our MSMA legislative team of David Roberts, Sara Hartzog, and Claire Hester, MSMA was offered a face-to-face discussion with Speaker Phillip Gunn on Thursday, February 16. Speaker Gunn felt that the bill was an expansion of Medicaid and that he was opposed to any expansion of Medicaid. He believed the Governor and Director of Medicaid saw no need to expand postpartum services because neither one had directly asked him to expand or extend these services. He had not received any word from the Director of Medicaid that the extension was needed. Dr. Anita Henderson, a pediatrician, and Dr. Randy Henderson, a neonatologist, and I spoke with the Speaker and presented the importance of this critical time for healthcare for new mothers. The Speaker was firm in his position and felt that postpartum coverage was no different than expansion of Medicaid for coverage with adults with all conditions like diabetes and hypertension.

We left the speaker’s office with a sobering reminder of how the political and legislative system works. Not to throw in the towel just yet, our MSMA legislative team arranged a press conference for the following week, on Wednesday, February 22, at the Capitol. MSMA sent out a Call to Action to mobilize the association to spread the word regarding the press conference at the Capitol.

Interestingly, on February 19, another statewide elected official, Attorney General Lynn Fitch, penned an editorial in support of the postpartum bill passed by the Senate and referred to the House.

The press conference at the Capitol was attended by many MSMA physicians and medical students. It was also attended by several legislators in support of the bill and included journalists from the local, statewide, and national media outlets. During the press conference, MSMA explained our position, including data and the reasons why the bill is important for Mississippi. Both Dr. Anita Henderson and Dr. Michelle Owens delivered a powerful message of clinical anecdotes and medical data to support the extension of these postpartum services.

Leaving the press conference on Wednesday, we felt we did our part for MSMA to tell the stories of Mississippi physicians and Mississippi patients, but the bill would likely not make it out of the House committee. On Saturday, February 25, we learned that Texas Republican Governor Greg Abbott approved an extension of postpartum services to 12 months. On Sunday, February 26, we learned that our own Mississippi Governor Tate Reeves supported the extension of these services to 12 months. He stated that he would sign a bill if it made it to his desk. On Monday, February 27, the Director of Medicaid delivered the letter of support to the Speakers office.

Tuesday, February 28, was the deadline for general bills from the Senate to make it out of committee and continue to survive. One media outlet reported that the Speaker would support a vote out of the committee if the Division of Medicaid and the Governor supported it. Another MSMA Call to Action was sent to encourage everyone to contact members of the House Medicaid Committee. By 10:00 am on Tuesday, February 28, the House Medicaid Committee reported the bill out from the committee.

Today, writing this president’s page, the fate of the Medicaid postpartum extension lies on the floor of the House of Representatives with a deadline to bring it up for discussion by March 9. No one knows if it will survive as it is written or be amended. No one knows if it will be acted upon by the Governor by Executive orders. We do know that just when we think the bill is dead, it keeps on going. Multiple factors including a large public response, behind the scenes discussions by physicians, and local editorial media all played a role. Every little factor appears to help the bill regain momentum. Passage or not, it has transformed into another example of the power of organized medicine and how quickly political views can change in 12 days.

All of these actions support what MSMA feels is simply the right thing to do. Every factor and influence from many different perspectives added to the tidal wave of support which caused a shift in the tide of political support at each step of the legislative process. This process speaks volumes for the power of organized medicine and advocating for physicians and patients.