New mothers in Wyoming enrolled in the Medicaid Pregnant Women Program lose their health insurance 60 days after giving birth, but a new bill making its way through the state's 67th Legislature would extend coverage for a full year.

Marissa Carpio, policy associate for the Wyoming Women's Foundation, said having health insurance is the number one determinant of good health, for mothers and newborns.

"Having health insurance means that you're more likely to seek preventive care, or get that odd symptom checked out that maybe arose during birth or after birth," Carpio observed. "And to not have to sacrifice the funds for your food or your rent to go figure out those health complications."

House Bill 4, sponsored by the Joint Labor, Health and Social Services Interim Committee, is now on General File and could get its first vote today.

Some critics have argued expanding coverage for new mothers is unnecessary because assistance is already available through Medicaid's Family Planning program. Newborns remain eligible for health insurance during their first year.

Carpio pointed out the family planning program is not comprehensive, it only covers gynecological exams and lab tests. It does not cover health issues including heart disease or stroke, which are leading causes of death for new mothers.

Working women of childbearing age are currently the largest group in Wyoming without insurance, largely because they are less likely to get coverage through their employer.

"They're more likely to be working part-time, low-paying jobs that don't offer insurance anyway," Carpio noted. "This type of program that is so specific to new mothers in our state is very important for the success of babies and communities."

According to the Wyoming Department of Health, nearly one in five new mothers participating in the Medicaid Pregnant Women Program currently end up losing health insurance.

Carpio believes healing after birth is a long and important process, and access to care will help women avoid financial and health-related stress, return to work and attain economic self-sufficiency.

"The biggest and most important thing is that continuous coverage after birth," Carpio emphasized. "When you're trying to raise a newborn child, trying to get back to work, the last thing you want to do is try to get your health insurance back to go see the doctor. You should be able to see the doctor when your family needs to."

With concerning trends emerging for pregnant and postpartum women, frustration is growing that Idaho lawmakers could end the session without addressing these issues.

The maternal mortality rate doubled each year between 2019 and 2021 in Idaho. The state also ranks last for income eligibility for pregnant women on Medicaid.

House Bill 201 would have extended Medicaid coverage from 60 days to 12 months after birth but has not received a hearing.

Hilarie Hagen, health policy associate at Idaho Voices for Children, said a large coalition of health care organizations, providers and families supported the legislation.

"Providing access to affordable health coverage helps reduce maternal mortality rates, improves birth outcomes, and Idaho's maternal health trends are going to continue on their downward trajectory every year we don't take action," Hagen stressed.

Rep. John Vander Woude, R-Nampa, chairman of the House Health and Welfare Committee, said he was supportive of the bill, and he had received a number of calls in support of it. However, Vander Woude noted the committee will not hold a hearing on it this session because he believes the Legislature has to get control of the Medicaid budget first.

This week, Bonner General Hospital in Sandpoint announced it would no longer deliver babies because of a provider shortage. The hospital also cited Idaho's legal and political climate as part of the reason for closing its maternity ward.

Hagen pointed out the provider shortage has become exacerbated in recent years.

"We are increasingly seeing providers choose to leave the state because of policy decisions made by Idaho lawmakers," Hagen asserted. "It's really discouraging to see that we are reducing access for moms and their babies."

Another measure unlikely to pass this session is House Bill 81, which would have extended the federally funded Maternal Mortality Review Committee passed its sunset date in July. Hagen emphasized Idaho will be the only state in the nation without a Maternal Mortality Review Committee.


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Research from The University of Utah explores the physical- and mental-health implications of social belonging in women.
Study author Lisa Diamond said disproportionately high mental- and physical-health problems among marginalized people have been written off as "minority stress," the cumulative chronic stress experienced because of discrimination and unfair treatment and said the missing piece is what is known as "social safety," the reliable social connections, belonging and sense of protection individuals foster in their social networks.

Through her research, Diamond found women who occupied one or more marginalized categories such as those relating to race, sexuality and gender reported significantly lower social safety, leading to a greater risk for physical and mental problems.

"That sense that you have people around you that are connected to you, invested in you, that you matter to. That feeling is a critical component of human health," she said. "It is not optional. It's not like the icing on a cake. It's the cake."

Diamond added the mental and physical effects one can endure do not depend so much on what type of marginalization they experiences, but rather from the mere fact of being discriminated against and misunderstood. She said a crucial aspect to good mental and physical health is ensuring access to safe and affirmative social ties.

Diamond said the unpredictable and unprecedented COVID-19 pandemic ripped everyone's social safety right out from under them, leaving many feeling isolated. She added while remote work and online school ushered in by the pandemic have their benefits, many are still struggling to recuperate the sense of safety and normalcy they lost which has made many deficient to the "basic nourishment of affirmative social connection."

"We should think carefully about the way we structure our days and our lives, and make sure that we are prioritizing the face-to-face connections that are meaningful to us. We need that, a lot more than we thought we did," she said.

She encouraged state policymakers and community leaders to adopt what she calls a "safety first" approach which begins by identifying whether an individual has access to relationships and people who can provide them with affirmation, protection and belonging.


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New data from the Centers for Disease Control and Prevention show another increase in the nation's maternal mortality rate, and a Minnesota expert says there are several underlying factors.

The report, released last week, covers data from 2021. That year, deaths of pregnant women or new mothers in the U.S. went up by nearly 40% over the previous year.

The agency says it follows gradual increases leading up to the pandemic as well.

Dr. Stephen Contag is an associate professor in the Maternal-Fetal Medicine division at the University of Minnesota Medical School. He said improved reporting is playing a role.

But he added that there are other issues at play.

"Disparities in transportation," said Contag. "Getting to health care. Or differences in the number of obstetricians or health providers that can provide that care to patients in certain parts of the country."

The findings show that Black women are especially affected by this issue. The maternal mortality rate for this population rose by nearly 70%, compared with nearly 25% for white women.

Some health experts say COVID-19 likely played a role in the 2021 spike, and that the big jump may have peaked. But there's concern the other factors will keep pressure on these rates.

The maternal death disparities have been documented in Minnesota as well. Contag said he sees hope in reversing trends, including changing how the state's Maternal Mortality Review Committee works.

The panel is now operating under a mandate.

"Now that we have that mandate," said Contag, "it's much easier to obtain the information that we need to review these cases in a fair manner."

He suggested that will lead to more recommendations that get to the root causes of these deaths.

And earlier this year, a new Minnesota law took effect, expanding postnatal care by requiring public and private health plans to cover a series of care visits for up to 12 weeks after a baby is delivered.

Two of those visits would have to involve comprehensive care.




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