Report calls for Medicaid changes to address maternal health in Arkansas

LITTLE ROCK, Ark. (AP) — A panel formed by Arkansas Gov. Sarah Huckabee Sanders to address maternal health on Thursday called for several changes to Medicaid, including quicker coverage for pregnant women and providing reimbursement to doulas and community health workers.

But the report issued by the Arkansas Strategic Committee for Maternal Health did not call for expanding postpartum Medicaid coverage to one year, an expansion adopted by nearly every other state but opposed by Sanders.

Sanders, a Republican, formed the committee in March to “improve health outcomes for pregnant women, new moms, and babies.” Many of the proposed changes focused on changes to Medicaid, which the report said covers between 50% and 60% of all pregnancies in the state annually.

“As the first mom to lead Arkansas, maternal health is personal. I’m not interested in headline-grabbing policies or duplicative government programs that don’t actually change maternal health outcomes,” Sanders said in a news release. “Instead, this Committee pursued a comprehensive, coordinated approach that will help healthier moms have healthier babies.”

Sanders earlier this year opposed expanding postpartum coverage for new mothers on Medicaid from 60 days to a year, making Arkansas the only state to not pursue the option. Sanders has said the state needs to do a better job of transitioning women to other coverage after their Medicaid eligibility ends.

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One of the committee’s recommendations called for the state implementing “presumptive eligibility” for Medicaid-eligible pregnant women, a move that would allow them to receive temporary coverage while their application to the program is being considered.

“Medicaid pays for more than half of the pregnancies in our state, so it’s critical that we optimize the system so that care is available and encouraged every step of the way before, during, and after birth,” Janet Mann, Arkansas Department of Human Services deputy secretary of programs and state Medicaid director, said. “These recommendations put in place significant changes that will remove barriers, improve care, and lead to better health outcomes.”

Other Medicaid recommendations including evaluating and looking at increasing reimbursements to providers to expand access. It also called for improving the identification and referral of pregnant and postpartum women at risk of losing coverage.

The expanded postpartum coverage gained support in Republican states since the U.S. Supreme Court in 2022 struck down Roe v. Wade, with GOP supporters of the move calling it key to their anti-abortion agenda. An Arkansas law banning nearly all abortions took effect immediately when Roe was overturned.

Forty-seven states have implemented the one-year coverage while Idaho and Iowa are planning to do so, according to KFF, a nonprofit that researches health care issues. Wisconsin had extended coverage to 90 days, and a one-year extension has been proposed in the Legislature.

Elisabeth Burak, senior fellow at Georgetown Center for Children and Families, said while the Arkansas report makes good recommendations, the state not pursuing the postpartum extension is a “flagrant omission.”

“It’s great to see that there’s a priority on this. But if you have a priority truly on maternal health, then why not do something that you’ve got this easy option to do and keep women whole with coverage during a stressful time in their life, and that research supports?” Burak said.

More than 100 people representing dozens of organizations met to help develop the recommendations, the committee’s report said. Other recommendations called for creating a dashboard to track key maternal health indicators, increasing the number of obstetrics and gynecology residencies in Arkansas, and developing a maternal health education and advertising campaign.