Missouri Republicans back Medicaid expansion for new moms, babies

The measure, sponsored by Sen. Elaine Gannon, R-De Soto, and Sen. Tracy McCreery, D-Olivette, is part of a renewed, bipartisan effort to extend Medicaid coverage following the birth of a child as a way to help bolster positive health outcomes in both the infant and the new mom.

"We feel it's one of the most important bills we can pass out of this chamber. We're talking about the most vulnerable population," Gannon said. "They are pleading with us to get this done," McCreery said. "It makes me a little sad we have to sell this so hard."

The state currently offers the government-funded insurance coverage for two months after a baby is born, but most acknowledge a longer coverage period could help address Missouri's high maternal mortality rate.

An average of 61 women died each year between 2017 and 2019 while they were pregnant or within a year of their pregnancies, the Missouri Department of Health and Senior Services said in a recent report.

The report added that three out of every four pregnancy-related deaths were preventable.

"I think we have to always remember that healthy moms means healthy kids," Gannon said.

The extended coverage period has received heightened attention in the Republican-controlled General Assembly now that nearly all abortions are outlawed in Missouri after the U.S. Supreme Court overturned Roe v. Wade in June. The plan has the backing of anti-abortion lobbying groups.

"This gives another set of professional eyes on the baby," said Sen. Holly Rehder, R-Sikeston, who said the extension would benefit rural areas she represents.

But, some conservative members of the upper chamber worked to block or limit when the coverage would start over their longstanding opposition to Medicaid expansion, which was ushered in by former President Barack Obama and not allowed in Missouri until voters forced the matter in an August 2020 statewide vote.

Sen. Bill Eigel, a Weldon Spring Republican who is exploring a 2024 run for governor, argued in favor of language that stated the added months of coverage should not go into effect until all recipients of Obamacare are reevaluated to determine if they remain eligible for the program.

Eigel and Sen. Mike Moon, R-Ash Grove, argued in favor of a vaguely worded provision that could bar women who have violated state law from receiving the benefit.

Moon and freshman Sen. Jill Carter, R-Neosho, also raised concerns that a woman could receive the extended coverage if she voluntarily aborted the baby.

Along with the Senate bills, at least five similar initiatives have been introduced in the Missouri House.

The governor also has made the issue a priority this year, putting $4.4 million into his budget proposal to implement a new maternal mortality prevention plan to provide support and address preventable deaths of expecting and postpartum mothers.

An estimated 4,565 women would have coverage extended if the bill passed. The proposal could cost $10.7 million by 2025, a legislative analysis of the measure noted.

The DHSS report showed that the risk of pregnancy-related death for Black women was more than three times as high as the risk for white women.

The state also tracked when women were dying, finding that the "greatest proportion of pregnancy-related deaths occurred between 43 days and one year after pregnancy" — meaning many deaths occurred after the state's 60-day cutoff for Medicaid coverage.

The proposal needs a final vote in the Senate before it heads to the House for further debate.

The legislation is Senate Bill 45.

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