Governor, legislators unveil maternal health package

Amidst a backdrop of moms with babies, Gov. Sarah Sanders on Thursday (Feb. 6) unveiled at the state Capitol her much anticipated maternal health care package aimed at improving Arkansas’ low national ranking.

The omnibus “Healthy Moms Healthy Babies” bill, which will be carried by Sen. Missy Irvin, R-Mountain View, and Rep. Aaron Pilkington, R-Knoxville, will tackle a variety of issues related to pregnancies and births including presumptive eligibility for pregnant women in the state’s Medicaid program, unbundling and increasing payments for pre-birth checkups and deliveries, and creating more access to maternal health care through doulas, community health workers, and telemedicine.

“I’m a mom, so I know how important maternal health care is to helping healthy moms have healthy babies, which is why my administration has been focused on building a comprehensive, coordinated approach to maternal health in Arkansas,” said Sanders. “Along with the actions we have taken since I took office, the Healthy Moms, Healthy Babies Act will make real, lasting change to Arkansas’ maternal health landscape and move the needle on this critical issue facing our state.”

The total price tag for the reforms the governor outlined is roughly $45 million, which state officials say will utilize $13 million set aside in the budget and the rest coming from federal matching funds.

According to Health Department data from 2018-2020, Arkansas had 35 pregnancy-related deaths per 100,000 residents. The department said 92% of those deaths were estimated to be preventable.

Roughly, 31% of maternal deaths are pregnancy related, while nearly 61% are pregnancy associated, but not necessarily related. Disorders of the cardiovascular system were the leading causes of pregnancy-related deaths, although other underlying causes of pregnancy-related deaths were cardiomyopathy, cardiovascular conditions, hypertensive disorders of pregnancy, infections, and hemorrhage. With these statistics, Arkansas has ranked last in the nation for maternal health.

The state pays for 17,000-19,000 births a year through its Medicaid program, which equates to about half of all births in the state.

The legislation outlined today includes several reforms recommended by the Governor’s Strategic Committee on Maternal Health, which Sanders formed last year. It establishes:

• Presumptive Medicaid eligibility for pregnant women, meaning pregnant women can receive prenatal care while they complete their Medicaid application during the first 60 days;
• Reimbursement pathways for doulas and community health workers;
• Establishes pregnancy-related Medicaid coverage for remote ultrasounds, remote blood pressure monitoring, and continuous glucose monitoring; and
• Unbundled Medicaid payments for pregnancy care, paying for up to 14 prenatal and postnatal care visits, encouraging providers to work with pregnant women so they attend more appointments.

The governor also announced Medicaid will increase reimbursements for traditional deliveries and cesarean sections by 70%, an issue that health care providers said is necessary to improving access and health. A c-section delivery costs on average $1,632, but will be increased to $2,914. Payments for a regular delivery will be increased from $1,435 on average to $2,870.

No federal waivers are needed for these changes, officials said, but there will be changes to the state’s Medicaid plan that will involve rules to be altered once the legislation is approved.

“Arkansas mothers and babies are our first priority,” said Irvin. “Today’s announcement and subsequent legislation is intentional, targeted and smart. It is designed to help our mothers be healthier so they can deliver healthier babies. Unbundling and increasing payments for prenatal, delivery, and postpartum care is necessary, way past due, and will make a huge impact in stabilizing our health care access for expecting mothers. I look forward to presenting this plan of action to prioritize and improve maternal health in Arkansas. I applaud the excellent work of our governor, Secretary (of the Arkansas Department of Human Service Kristi) Putnam, our teams at DHS and the governor’s office.”

“The Healthy Moms, Healthy Babies Act strengthens maternal care in Arkansas by unbundling the global payment, increasing provider reimbursements, and expanding access to telemedicine,” said Pilkington. “This bill also improves pregnancy outcomes by empowering community health workers and ensuring Medicaid coverage for expectant mothers.”

Talk Business & Politics will update this story later today.