Wisconsin Democrats introduce bill expanding private insurance coverage for postpartum mothers and newborns

Legislation introduced by Wisconsin Democrats would expand private health care benefits for new mothers and babies. But its future is uncertain before the Republican-controlled state legislature.

The bill was introduced a week after Republican lawmakers on the Joint Finance Committee voted against a $34.5 million provision in Democratic Gov. Tony Evers’ proposed budget that would have expanded Medicaid coverage for mothers up to a year after giving birth.

Meanwhile, a similar but bipartisan effort to expand Medicaid coverage for postpartum mothers is making its way through the state legislature and has been referred to both Assembly and Senate committees.

But instead of focusing on expanding Medicaid in Wisconsin, the Senate bill from Democrats would focus on private insurance companies. They would be required to cover maternity, postpartum and newborn care at no or limited cost, with some exceptions. Such exceptions include, but are not limited to, liability insurance, credit-only insurance, and medical automobile payment insurance.

Senate Minority Leader Melissa Agard, a Democrat, is a major sponsor of the legislation. She said she aims to improve maternal and child outcomes in Wisconsin, which are among the worst in the nation.

“This bill would essentially enshrine the federal protections and coverage from the Affordable Care Act into Wisconsin law,” Agard said. “There shouldn’t be any discrimination in health care in the state of Wisconsin, and certainly, maternal and child success in the state of Wisconsin absolutely must be better.”

For years, the United States has had the highest maternal mortality rate of pregnant women who die in childbirth or in the weeks following childbirth compared to other wealthy nations. But the rate is up 40% in 2021 from a year earlier, according to a report from the National Center for Health Statistics.

In Wisconsin, more than 2 out of 3 pregnancy-related maternal deaths occur after delivery. Black mothers in the state are five times more likely to die than white mothers.

Agard called these disparities “huge” and criticized fellow Republicans for failing to sign the bill, saying every Wisconsin citizen should have access to high-quality health care, especially mothers and children.

“This is a priority that I think the party that beats the drum on family values ​​should be able to get around,” he said.

In Wisconsin, health insurance companies must provide coverage the moment a child is born, according to the Wisconsin Office of the Insurance Commissioner. This cover includes treatment of birth defects and birth defects as injury or illness under the policy.

Every group disability insurance policy that provides maternity cover is already required by law so as not to exclude anyone who is eligible for cover.

Under applicable law, mandatory non-Medicaid maternity coverage benefits apply only to group insurance. This bill would change that by requiring insurance commissioners to provide no-cost or limited-cost maternity and newborn care benefits, according to the nonpartisan Legislative Reference Office. The bill also includes a provision that states that if maternity or newborn care is subject to mandatory coverage elsewhere under a state law, the person receiving the insurance must receive comprehensive care.

Under current law, pregnant women with family incomes up to 300 percent of the federal poverty level are eligible for extended Medicaid benefits for at least 60 days after giving birth. A provision added to the state budget last year sought to increase it to 90 days, but is still awaiting approval from the US Department of Health and Human Services.

Assembly Speaker Robin Vos, a Republican, has voiced his opposition to expanding Medicaid coverage for postpartum care.

“I don’t think it’s fair to give it away for free, to be honest. I think everyone, when you choose to have a child, which I’m glad people do, it’s not the taxpayers’ responsibility to pay for that child to be born,” he said. Vos said at a Wisconsin Health News luncheon on June 13.

Emily Kittell is the maternal and child health initiatives manager for the Wisconsin branch of the March of Dimes advocacy group. She said research shows that in Wisconsin, nearly 97 percent of maternal mortality, or death caused by pregnancy-related problems, is preventable. And mental health problems contribute to a large number of maternal deaths.

“That means we’re not doing a good job right now to get those pregnant women the health care they need,” she said. “We shouldn’t be seeing people dying from treatable complications, including mental health problems.”

In the United States, 36 states, including conservative states, have extended coverage to 12 months postpartum. Kittell said that makes Wisconsin an outlier.

Agard agreed that expanding health care for new mothers and babies shouldn’t be a partisan issue.

“Every woman in Wisconsin deserves the highest quality health care and affordable health care, during pregnancy and after pregnancy,” she said.

At this point, no groups have registered for or against the bill. The proposal has at least 30 Democratic co-sponsors and no Republicans. Similar bills introduced in 2019 and 2021 failed to pass either the Senate or the state Assembly.