FL moms have gotten expanded Medicaid coverage following childbirth, but not many people knew it

A major initiative pushed by Florida House Speaker Chris Sprowls to expand Medicaid coverage for women and babies has been happening for more than a year — a surprise to lawmakers who were getting antsy about the launch of the new program for postpartum moms.

Sprowls pushed to expand Medicaid coverage for mothers and babies, from 60 days to a full year following childbirth. The 2021 Legislature approved the program, and Florida is awaiting federal approval to get the effort going.

But with the nation under a public health emergency during the COVID-19 pandemic, the federal government has allowed states to expand the Medicaid coverage well beyond the original 60 days following childbirth.

In fact, the effort began as early as March 2020 for those women, health policy experts told the Florida Phoenix.

Lawmakers probably were unaware of the federal law that grants continued Medicaid coverage to pregnant women, said Anne Swerlick, senior policy analyst at the Florida Policy Institute.

Medicaid expansion overall has been a tough subject for years in Florida, with advocates and Democrats pushing to expand Medicaid so more low-income people could get health care. But the GOP-controlled Legislature has been against the expansion, and only 12 states, including Florida, haven’t expanded Medicaid overall, according to an analysis from the Kaiser Family Foundation (KFF).

Following a Biden administration initiative, Sprowls, a Republican, focused on a specific Medicaid program, to extend Medicaid coverage for a full year to low-income women after they deliver their babies.

At the time, Sprowls didn’t mention President Joe Biden’s $1.9 trillion stimulus package signed earlier that March, which included a change to Medicaid coverage for pregnant women facing gaps in maternity health care. States had the option to provide the extended Medicaid health coverage.

During the 2021 session, lawmakers passed legislation (SB 2518) to extend postpartum Medicaid coverage and Sprowls spearheaded the effort to spend nearly $240 million in the 2021-22 state budget for the program.

That program is awaiting full approval from the federal Centers for Medicare and Medicaid Services, and it’s still not clear when it will commence. The legislation became law July 1 and it’s now almost October.

During a recent committee meeting this month, state Rep. Michael “Mike” Caruso, a Republican representing part of Palm Beach County, expressed concerns about the “health and wellbeing” of Florida residents waiting to take advantage of the new law related to Medicaid coverage for mothers.

“It just seems like a long process to implement these laws,” he said, adding that health agency leaders should look at ways to expedite the process.

Tom Wallace, deputy secretary for Medicaid at Florida’s Agency for Health Care Administration (AHCA), explained during the committee meeting that the process has been slow because of the pandemic.

But the agency has submitted a “federal waiver amendment” in September to the federal Centers for Medicare and Medicaid Services (CMS). The agency held a 30-day public comment period,” required by federal law, Wallace added, and “all comments received by the agency were supportive of this policy change.”

Wallace also told lawmakers that because of the federal Families First Coronavirus Response Act, “everyone under this public health emergency is covered right now.”

That includes women already receiving ongoing access for postpartum Medicaid coverage because of the public health emergency.

The Florida Phoenix is awaiting a response from Speaker Sprowls regarding whether he was aware of the public health emergency that allowed expansion of postpartum Medicaid coverage.

According to the Kaiser Family Foundation (KFF), the Families First Coronavirus Response Act that became law in March of 2020 requires states to “provide continuous coverage to Medicaid enrollees through the public health emergency (PHE) period.

But once the public health emergency ends, states must submit a federal waiver or use state funds to continue the extended postpartum coverage, according to KFF. (Florida has submitted its waiver.)

Swerlick, of the Florida Policy Institute, told the Phoenix that she believes the public health emergency will “likely go to the end of the year.”

It’s important to understand that the federal public health emergency is different than Florida’s state law when it comes to the postpartum Medicaid expansion program.

Swerlick explained in an email to the Phoenix:

“The continued coverage for postpartum women since March 2020 has nothing to do with the change in state law. It is tied to the federal Families First Coronavirus Response Act enacted in March 2020.  This law does not say anything about the number of months or years this requirement is in effect — but rather that it must stay in place for the duration of the federal public health emergency.

“This means that any women who were receiving postpartum coverage in March 2020 and any women who have qualified for this coverage since then have remained Medicaid eligible. So, for some of these women this means that they have had coverage for more than one year.”

Meanwhile the state’s legislation on the issue is moving ahead at the federal level.  A spokesman for Florida’s Agency for Health Care Administration said, “The agency is confident that waiver approval will come quickly.”

“Moms need healthcare before, during, and after birth. Extending Medicaid’s postpartum coverage from two months to 12 months is a critical step toward improving maternal and infant health outcomes, and to reducing disparities,” said Alison Yager, executive director of the Florida Health Justice Project.

“Our next priority must be to ensure continuous coverage across the life course by expanding Medicaid.”

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