For the second year in a row, Mississippi House leadership has once again killed an extension of postpartum Medicaid benefits, likely guaranteeing that many low-income people will lose health insurance benefits only two months after giving birth.
In February, the Mississippi Senate passed Senate Bill 2033, which would have extended coverage to 12 months if the House had also approved it, in a 46-5 vote. Yesterday, the bill died for the second year in a row, victim to political gamesmanship.
Under current state Medicaid provisions, new mothers have access to medical insurance through Medicaid for only 60 days, with benefits ending abruptly after that time. The following months are some of the most dangerous for new mothers, and cutting off care ends the diagnostic and treatment interventions that could otherwise save lives.
Cassandra Welchlin, executive director of the Mississippi Black Women’s Roundtable, told Mississippi Free Press reporter Ashton Pittman in a Wednesday interview that the decision to kill the bill would have dire consequences for the state.
“We are really shocked and disappointed that this bill has died, given the great benefits it would provide to women across the state who are pregnant and who have just had babies,” Welchlin said.
‘Keep People Off’
This is the second time that the postpartum extension has fallen victim to the legislative artifice of a divided GOP. Previously, the benefit died in a political turf war over 2021’s Medicaid Tech Bill, ripped out of the dense legislation at the last moment.
Now, the standalone bill perishes on the calendar thanks to Rep. Joey Hood, R-Ackerman, chairman of the House Medicaid Committee, and Speaker Philip Gunn, R-Clinton. This time, Gunn acknowledged to Associated Press’ Emily Wagster Pettus that his decision to spike the bill came from a fear of the appearance of “Medicaid expansion.”
“As I’ve said very publicly, I’m opposed to Medicaid expansion,” Gunn told the AP on March 9. “We need to look for ways to keep people off, not put them on.”
Gunn is the immediate past chairman and a current board member of the American Legislative Exchange Council, a conservative organization that provides template legislation to statehouses across the U.S. ALEC is a staunch opponent of Medicaid expansion in states including Mississippi. Gunn’s notion that the bill constituted “Medicaid expansion,” a key component of former President Barack Obama’s signature health care law, is one the bill’s supporters have labored against.
Advocates like Sen. Kevin Blackwell, R-Southaven, chairman of the Medicaid committee in the Senate, have highlighted the fact that the bill would not have grown the pool of Mississippians eligible for Medicaid, but merely extended the length of time during which new mothers could access the benefits.
“In states that have enhanced this benefit, there are different provisions. In some, it’s six months, others up to a year. It provides (individuals), particularly the mother, with additional care. I just think it’s the right thing to do,” Blackwell told the Mississippi Free Press in an interview earlier in the session.
COVID-era provisions have temporarily extended the benefits for up to a year, but pandemic restrictions and protections waning with the case counts, this setback is likely to mark the coming end of the extension.
Highest Rate of Maternal Mortality
The death of the benefit is another setback to a potential solution for an enormous risk area for Mississippians. Between 2013 and 2016, Mississippi’s pregnancy-related maternal mortality rate was 1.9 times higher than the U.S. as a whole, and rates of postpartum mortality in particular are significantly higher than in other states where the overall rate of mortality for new mothers is much lower.
During the study period, “86% of pregnancy-related deaths occurred postpartum, including 37% after 6 weeks,” the Mississippi State Department of Health reported. The bill would have taken aim at a specific area of racial disparity: in Mississippi black mothers are three times more likely to die from causes related to pregnancy than their white counterparts.
“We know that the maternal mortality rate is very high among Black women,” Welchlin said. “And so this bill would have afforded life. For it to have died means more women are going to die because they don’t have the adequate, necessary health care that they needed. It’s shocking. It’s disappointing.”
Given the margin of support the bill enjoyed even among Republicans, it is highly unlikely that it would have perished without the personal opposition of Gunn and Hood considering the overwhelming support in the Senate. The question remaining, then, is what possessed the House to once again spike the legislation without even allowing it a hearing in committee or the House floor.
“I think that’s really a question that needs to be asked of lawmakers,” Welchlin said. “There really needs to be an inquiry—some accountability on why. Lawmakers are sent to the Capitol for the people. They did not honor the people who sent them there, the many women who make up Mississippi, those that live at the intersections of race, gender, economic justice and poverty.”
‘There Is No Genuine Answer’
The session is long and only growing longer. Already Gunn has raised ire across both houses of the Legislature by calling for the entire session to be upended in favor of a special session on his pet income-tax repeal plan. As the postpartum extension was killed last session after an extended knife-fight between houses, the question lingers—was yet another bill with broad bipartisan support and serious outcomes for Mississippians the victim of legislative infighting?
“That is a real question for them that needs to be asked and answered … to me there is no genuine answer,” Welchlin said. “We definitely have heard (these rumors). Was this bill part of a hostage situation because they want to get this income tax bill? Was this bill a trade off for something?”
Gunn, in his brief comments to the AP, presented himself as rather agnostic on the potential benefits of the expansion. Asked if the benefit might have saved lives, Gunn offered a noncommittal quote. “That has not been a part of the discussions that I’ve heard,” he said.
As House speaker, Gunn has used his power to pass several anti-abortion laws, including the 2018 abortion ban that the State has asked the U.S. Supreme Court to uphold in Dobbs v. Jackson Women’s Health Organization. During oral arguments in December 2021, the court’s conservative majority appeared ready to use the case to strike down Roe v. Wade, the 1973 ruling that outlawed pre-viability abortion bans nationwide.
“On this the 49th anniversary of Roe, we mourn the lives lost, and pray that in the Dobbs case our House bill ending most abortions after 15 weeks will be upheld,” Gunn tweeted on Jan. 22, 2022. “It’s time for our nation to finally turn the corner towards protecting life.”
Mississippi has the highest infant mortality rate in the nation and the highest rate of residents without health care coverage. To Welchlin, GOP attempts to paint the state as the “safest for the unborn” are deeply hypocritical in light of the harm facing mothers after birth.
“It’s really hypocritical to me that you’re saying you want life, that you want the baby’s life (when) this bill would have really paired well with their philosophy that life extends also to that mother. The mother’s life is a lifeline to that baby,” she said.
“We know that there are some legislators over there, like Senator Blackwell, who fought hard for this. Other legislators fought hard for this. But (the question of what happened) needs to be asked of the speaker and of Joey Hood. There needs to be real accountability for that.”
Neither Speaker Gunn nor House Medicaid Chairman Joey Hood responded to requests for interviews.