7 Things to Know About Recent Federal Actions and Opportunities to Improve Maternal Health

May 12, 2021 | Alyson Kelly Northrup, Carolyn McCoy

Smiling-pregnant-woman-in-park_1200x740.jpgWhile the Biden Administration and Congress have no shortage of immediate health issues to focus on, improving maternal health outcomes—particularly Black maternal morbidity and mortality—have become a priority for federal lawmakers. To make sense of what’s going on, ASTHO staff partnered with the Association of Maternal and Child Health Programs (AMCHP) to outline the seven things to know happening on the federal level right now. Read more below.

    1. On April 13, the White House issued the first ever proclamation recognizing Black Maternal Health Week, which is an annual event founded and led by the Black Mamas Matter Alliance. The proclamation called on “all Americans to recognize the importance of addressing the crisis of Black maternal mortality and morbidity in this country.” This statement from the very top of the Executive Branch that maternal health, specifically Black maternal health, is a priority for the federal government sets the tone and raises an expectation of significant investment in eliminating racial disparities in maternal health outcomes over the next four years of the Biden Administration.
    2. “Momnibus”—combining the legislative term “omnibus” with the word “mom.” An omnibus is when a bill combines several other bills together in one larger package. The Black Maternal Health Momnibus Act is a collection of legislative proposals – 12 stand-alone bills – that seeks to improve health outcomes for Black moms – hence “Momnibus.” The bill is championed by the bipartisan Black Maternal Health Caucus and would build on existing proposed legislation to comprehensively address the maternal health crisis in the United States. On May 4, the Protecting Moms Who Served Act became the first bill in the Momnibus to advance of out committee, bringing the bill one step closer to becoming law.
    3. Congress has an opportunity right now during “appropriations season”—when Congressional members write the funding legislation for the coming fiscal year—to make significant investments in existing federal programs to improve maternal health. AMCHP and ASTHO support increasing funding for the Title V Maternal and Child Health (MCH) Block Grant to $750 million in fiscal year 2022 (FY22). This would be a 5% increase above the current funding level of $712.7 million. State formula funding through the Title V MCH Block Grant supports programs that serve 92% of pregnant people in the United States. Addressing the maternal health crisis is a significant focus of the Title V MCH Block Grant, including through programs like the Alliance for Innovation on Maternal Health and State Maternal Health Innovation grants. Increased funds are necessary to respond to long-standing as well as emerging needs, including the impact of the COVID-19 pandemic on maternal and child health populations. Both organizations are also in the nascent stages of advocacy for the Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) that supports the delivery of coordinated and comprehensive, high quality, voluntary, evidence-based home visiting services to children and families living in communities at risk for poor maternal and child health outcomes. MIECHV authorization is set to expire at the end of fiscal year 2022.
    4. Congress can fully fund the Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET) at CDC, which will equip the United States with the nationwide preparedness and response network the country needs to protect pregnant people and infants from emerging public health threat. Building on a mom-baby linked data collection approach developed in response to the Zika outbreak, SET-NET leverages existing data sources to enable CDC and health departments to detect the impact of new and emerging health threats, like COVID-19, on pregnancy and birth outcomes. In FY21, SET-NET provided support to 29 state, local, and territorial health departments to monitor the impact on pregnant people and their babies of exposure to Zika, syphilis, hepatitis C, or COVID-19.The latest published findings from SET-NET data showed that pregnant people with COVID-19 may be at increased risk of having a preterm infant compared to pregnant people without COVID-19. Fully funding SET-NET at $100 million would enable CDC to scale this critical data infrastructure program nationally.
    5. The Biden Administration’s American Families Plan calls for a $3 billion investment in maternal health. The next step in the process is for Congress to draft a bill, though right now it is unclear if such proposal will garner bipartisan support.
    6. The American Rescue Plan Act that President Biden signed into law in March included a provision to support state efforts to extend Medicaid coverage to 12 months postpartum by creating a new Medicaid state option (also called a State Plan Amendment) to pursue this policy. The policy takes effect April 1, 2022 and remains available to states for a five year period. It is likely that Congress will try to make this policy a permanent option this year.
    7. Centers for Medicare and Medicaid Services (CMS) recently approved Illinois’ request to provide full Medicaid benefits to postpartum women up to 208% of the federal poverty level for 12 months from the end of pregnancy. Illinois is the first state to receive approval for a Section 1115 waiver request of this kind. CMS subsequently approved Section 1115 waivers for narrower postpartum coverage extensions in Georgia and Missouri. We expect CMS to approve additional waivers of this kind in the coming year.

ASTHO and AMCHP will continue to monitor these changes from the federal government and will continue to keep its members informed.