HHS Takes Steps to Improve Maternal Health Outcomes Among Minority Women

WASHINGTON — The Department of Health and Human Services announced several actions Monday aimed at improving maternal health outcomes, especially among Black and Hispanic women.

“This is the start of Black Maternal Health Week, a week that reminds us that in the year 2021 maternal mortality in the U.S. is higher than in most other developed and high income countries,” said HHS Secretary Xavier Becerra during a press briefing. “That maternal mortality disproportionately affects Black and American Indian and Alaska Native women, and that there continues to be a disparity between rural and urban populations, is hard to believe.”

“Improving maternal health outcomes, particularly among black women is a priority for President Biden, Vice President Harris, and this administration, and of course for the Department of Health and Human Services,” Becerra said. He noted that Biden’s discretionary funding request to Congress for fiscal year 2022 includes more than $200 million to reduce maternal mortality and morbidity rates and race-based health disparities.

He announced that HHS has approved an 1115 waiver — the first of its kind — to allow Illinois to extend its postpartum coverage for Medicaid beneficiaries, which currently lasts 2 months, to up to 1 year. “This makes Illinois the first state to provide continuous coverage of full Medicaid benefits for mothers — regardless of change in circumstance — during the entire first year after delivery. That’s a big deal,” Becerra said.

“The postpartum period is an important part of maternity care and it’s a time when mothers may be dealing with a host of medical conditions. In the U.S., 52% of pregnancy-related deaths take place up to 1 year postpartum,” he continued, adding that the benefit “will help mothers manage chronic conditions like hypertension and diabetes and it will provide access to behavioral health and other mental healthcare services.”

Rep. Robin Kelly (D-Ill.) praised the waiver. “I was disheartened last week when I read the newly released report from the CDC which shows the maternal mortality rate continues to rise, and that risks of maternal death for women of color are only worsening,” she said. “What’s even more disheartening is that two-thirds of the deaths are preventable. But today we are going to celebrate the wins that continues to give us hope…. We are relieved that we’re here today to watch Secretary Becerra approve the waiver, and thousands of Illinois women will now have access to the postpartum care they deserve. This is an important step forward for Illinois, which has very high rates of maternal death, especially for women of color.”

Becerra urged other states to apply for the waiver, which was made possible through a provision in the American Rescue Plan recently passed by Congress. “We want states to join in; we want them to come on board,” he said. “I hope we begin to see states not only express interest but actually submit their proposal on how they would do this.”

Telehealth will be part of the assistance that the Medicaid beneficiaries get, Becerra said in response to a question from a reporter. “By making this emphasis on trying to expand care … I think you’re going to find that telehealth will be a critical part of any plan or proposal that moves forward to deal with not only increasing access to care but dealing with those who have been left out,” he said. “The 1115 waiver that Illinois is now receiving will give them a chance to do long-term planning beyond 60 days on how to make sure to stay in touch with a woman, whether it’s telehealth or otherwise. We’re providing an opportunity for the new mom and her family to have continuity of care.”

Rep. Lauren Underwood, RN (D-Ill.), agreed that “telehealth and telemedicine is part of a comprehensive solution but it does not at all equate and does not overshadow the impact of today’s announcement,” she said. “Telehealth is important but it doesn’t replace the need to grow and diversify the perinatal workforce,” something that Underwood and other House members are attempting to address in a series of maternal health bills known as the “Momnibus,” which has been introduced in the House.

In addition to the Illinois waiver, HHS also is making $12 million in grants available over 4 years through the Health Resources and Services Administration to programs working to expand access to care for pregnant women in rural areas, Becerra said. The Rural Maternity and Obstetrics Management Strategies program “is designed to develop models and implement strategies that improve access to continuity of maternal obstetric care in rural communities, and will help improve maternal health outcomes for underserved rural mothers, including black rural mothers,” he said. “For the first time, applicants are required to focus on populations that have historically suffered from poor health outcomes.”

Becerra added that HHS was going to put a specific focus on getting good data for its funding priorities. “Too often we miss communities because the data doesn’t point us in the direction of those communities; they’ve been left out,” he said. “Let’s make sure we include them at the beginning with data that drives us to provide healthcare to the right places.”