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On April 8, Alabama lawmakers unanimously passed a significant piece of legislation aimed at improving maternal health outcomes in the state. The new bill, known as the “presumptive eligibility” measure, allows pregnant women to receive temporary Medicaid coverage for outpatient medical care for up to 60 days while their applications for the program are processed. The legislation is now awaiting final approval from Governor Kay Ivey.
This legislative move addresses the alarming maternal and infant mortality rates in Alabama, particularly among low-income and Black women. A study by the Milken Institute revealed that Alabama’s maternal mortality rate was 64.63 deaths per 100,000 births from 2018 to 2021, nearly double the national average. For Black women, this rate soared to 100.07 deaths per 100,000 births.
The bill garnered bipartisan support, with legislators from both parties recognizing the urgent need for improved access to healthcare. Advocates have emphasized that the measure is critical for ensuring life-saving access to care, particularly as other southern states like Mississippi and Arkansas explore similar legislation to combat preventable deaths related to pregnancy and childbirth.
A report from the March of Dimes highlighted that nearly 20% of pregnant women in Alabama did not receive timely prenatal care, often due to limited access in rural areas where hospital closures have restricted availability. The state’s refusal to expand Medicaid under the Affordable Care Act has exacerbated this issue, leaving many low-income women in a coverage gap where they earn too much for traditional Medicaid but not enough for private insurance.
Currently, a pregnant woman in Alabama with no dependents must earn less than $21,996 annually to qualify for Medicaid. Many women lose coverage shortly after giving birth unless they meet different criteria.
The new presumptive eligibility bill is projected to increase state Medicaid spending by approximately $1 million annually over the next three years, with two-thirds of the funding expected to come from the federal government. Health advocates argue that this investment could lead to healthier pregnancies and reduced long-term healthcare costs associated with complications arising from inadequate prenatal care.
In addition to the presumptive eligibility measure, Alabama lawmakers are considering other proposals to enhance maternal care, including legislation that would allow licensed midwives to provide care in free-standing birth centers. However, recent amendments to this bill have raised concerns among supporters about potential restrictions on midwives’ ability to conduct essential newborn screenings.
Despite ongoing challenges, the passage of the presumptive eligibility bill marks a significant step toward expanding access to maternal care in Alabama. Lawmakers and advocates alike recognize that improving access to care during pregnancy is crucial for reducing preventable deaths and promoting healthier outcomes for both mothers and their babies.
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