Imagine you have a newborn. You have just had major surgery, a C-section, and are sleep deprived. You’re trying to feed and care for your new baby, manage your stress, and if you’re lucky, take a shower once a week.

Losing your health insurance is not just a terrible inconvenience; it’s a matter of life and death. For 5,000 women in Washington State, this is the reality.

If you are low-income and pregnant, you qualify for Apple Health for Pregnant Women. This covers women up to 198 percent of the federal poverty level (that’s $2,790 per month for a single mom) during pregnancy and has no immigration exclusions. Unfortunately, if you earn too much to be covered by Apple Health for Adults (above 138 percent FPL, or $1,945 for a single mom), coverage ends at around two months after giving birth. But we know your health needs don’t end just because you’re no longer pregnant.

Maternal mortality is a significant issue in the United States. Over the last two decades, the number of women who die each year from a pregnancy- or childbirth-related cause has skyrocketed by more than 50 percent. Many of these deaths are preventable.

Medical issues can include depression and anxiety, hemorrhaging, problems with breastfeeding, and trouble managing stress and substance use. The American College of Obstetricians and Gynecologists found that 25 percent of women experience depression after giving birth. Rates are higher among women of color and low-income women. Untreated behavioral health issues like postpartum depression can lead to suicide or drug overdose. One hundred percent of these deaths are preventable.

EOI is proud to support extending Apple Health to pregnant women to one year postpartum (SB 6128/HB 2381) because it will save women’s lives, address racial and ethnic disparities, increase women’s economic security, and have tremendous long-term cost savings.

Over 30 organizations support this policy, including the American College of Obstetricians and Gynecologists, Northwest Health Law Advocates, the Perigee Fund, the American Indian Health Commission, and the WA State Medical Association.

Why Washington Women Need Post-Partum Care for One Year

Our state’s Maternal Mortality Review Panel recommends access to postpartum care through the first year to prevent future deaths. The Review Panel was established by the Washington State Legislature in 2016 to address the maternal mortality crisis in our state.

• Extending coverage to women postpartum for one year will save money. A recent analysis found the total societal cost of untreated maternal mental health conditions in our state was $304 million for all 2017 births. Nearly half of these costs include the costs of caring for children, because children of mothers with perinatal mood and anxiety disorders have a higher risk of behavioral and developmental disorders. When women forego much needed care, their medical issues go untreated, causing them to rely on costly emergency care down the line.

• This is a racial equity issue. While women of all races are dying from pregnancy related complications, in Washington, American Indian and Alaska Native women are 6 to 7 times more likely to die as white women. Nationally, black women are 3.3 times more likely than white women to suffer a pregnancy-related death.
• Healthier moms mean healthier babies. Although infants are covered in low-income households, if moms can’t access care, it means they forego getting much-needed follow-up care. Existing health issues can be exacerbated by the stress and physical demands associated with caring for a newborn.
• It is well proven that access to health insurance during the first year of giving birth saves women’s lives. The death of a parent is an example of an Adverse Childhood Experience. These have negative consequences for the life of the child and for future generations; but they also often lead to higher health care costs.

Too many women are dying preventable deaths associated with pregnancy. Ensuring access to affordable health coverage for an entire year after giving birth will save lives, protect babies, and promote women’s economic security.

Do you want to testify for our hearing in Olympia on 1/20/20 or in possible future hearings, or share your story to help us pass this policy? Click here to share your story.