Medicaid can be a powerful tool to ensure that parents and caregivers have the health coverage they need to stay healthy and provide for their children. That’s why NC Child and our partners have consistently advocated for the expansion of Medicaid in our state over the last eight years. While the state legislature did not expand Medicaid during its 2021 session, they did create a new Joint Legislative Committee on Access to Healthcare and Medicaid Expansion – a huge step forward in bipartisan negotiations.
Legislative leaders also passed two new laws that will significantly improve Medicaid coverage for many low-income families in our state. NC Child and partners advocated for these life-saving parental coverage provisions – and both were included in the state budget that passed in November.
Addressing Infant & Maternal Mortality
First, new parents receiving pregnancy Medicaid will now be eligible for extended coverage for 12 months after the birth of their child. Senator Jim Burgin deserves special recognition for relentlessly guiding this vital legislation through a long and winding legislative process and into the final state budget.
Medicaid covers more than half of all births in North Carolina, providing essential health care to both the birthing parent and babies. One in three pregnant people experience a disruption in health insurance coverage before, during, or after pregnancy. This often includes losing insurance at a time when they need it most.
Ending postpartum coverage a few weeks after birth can result in severe and life-threatening medical issues like bleeding, infections, postpartum depression, and even death. Pregnancy-related deaths can occur up to one year after a baby is born. At least one-third occur after delivery. This policy change moves the end-of-coverage date from 60 days postpartum to twelve months of uninterrupted coverage, allowing the parent to bond with their baby, get care for common and life-threatening conditions that can occur after giving birth, and get appropriate contraception as needed.
In 2019, the rate of Black infant deaths was 2.66 times the rate for white infants, one of the widest disparities ever recorded in North Carolina, and 12% more than the rate two decades ago. This high rate is largely due to disparities in health care and birth outcomes that put families of color at higher risk. Black infants are more than twice as likely than infants in white families to die before their first birthdays. Extending postpartum Medicaid can ensure families can get the care they need, and promotes healthy development for babies.
Using Medicaid as a Tool for Family Reunification
The second important change in health coverage this year will support families in reuniting when their children are placed in foster care. Prior to this legislation, parents who had Medicaid coverage lost it if they lost custody of their children. Loss of coverage virtually eliminated parents’ ability to address physical, mental, and behavioral health needs that create barriers to reunification with their children.
As the numbers of children in North Carolina’s foster care system grow, the length of time spent in foster care has also increased – without enough foster families or other safe placements available to children. Allowing parents to keep their Medicaid coverage may help to reduce the amount of time children spend in foster care.
Thanks to this legislation, parents will maintain their Medicaid coverage, as well as their access to the health resources they need to recover and reunite with their children. We are grateful to Senators Britt, Burgin, and Krawiec, who sponsored this legislation and guided the bill to final passage.
Keeping up the Push for Medicaid Expansion
We are so pleased with both of these positive developments for parents’ health coverage in North Carolina. But we can’t lose sight of the big picture – that every parent and caregiver needs access to quality, affordable health coverage. As legislative leaders take up the issue of Medicaid Expansion this spring, we’ll keep advocating for the continuous, whole-person coverage that every family needs and deserves.