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The long-term economic and social costs of chronic illness, disability, and death for mothers excluded in this bill should not be ignored.
The Iowa Senate passed Senate File 2251, which would extend postpartum Medicaid coverage for women from the current 60 days to 12 months after the end of pregnancy. The proposed change would make Iowa the 48th state to expand postpartum Medicaid coverage, a long-awaited change that would make a difference in the lives and health of new parents in Iowa. become.
But this poses dangerous lifetime health costs for the approximately 1,300 women per month who would lose access to postnatal insurance because the bill sets a low eligibility bar.
I’m a mother of two and a researcher who studies the long-term effects of pregnancy complications on maternal health. Women who first develop complications such as high blood pressure or diabetes during pregnancy are up to 10 times more likely to develop diabetes later on and die from heart disease. Not only are these women more likely to suffer from chronic diseases, but they also develop these diseases and related complications at a younger age, even if they return to normal health after pregnancy.
Even if these women recover, they experience changes in their physiology that accelerate the progression of the chronic disease. The good news is that these changes are likely to respond to preventive care. But the time to reverse or treat these changes to prevent or slow disease is after pregnancy ends and before disease develops, just as this bill would reduce access to health care. It’s time.
All women should receive medical care long after pregnancy to educate them about lifelong risks, provide risk management counseling, and receive necessary preventive services. In fact, the Iowa Maternal Mortality Review Commission includes “improving postpartum Medicaid coverage” in its latest recommendations to reduce maternal deaths in Iowa. Lower socio-economic status and limited access to health care are both major risk factors for pregnancy complications, putting women at higher risk of future disease, disability, and death. Current Senate File 2251 expands health care access to the most vulnerable, but at the cost of putting other highly vulnerable women on a course for future disease and leaving their families with mothers. you are at risk of losing.
Certainly, this change would improve outcomes for women who maintain access to extended coverage and keep postpartum Medicaid coverage budget neutral in the short term. However, the long-term economic and social costs of chronic illness, disability, and mortality for excluded mothers should not be ignored. Gov. Kim Reynolds says she wants more aid for Iowa families. Iowa House of Representatives should consider the long-term risks to these patients and their families and amend the bill to maintain coverage at current income standards. Thousands of Iowa mothers and their families rely on it.
Anna Stanhewicz is an assistant professor of health and human physiology at the University of Iowa. Her views expressed in this essay are her own and do not reflect the views of her employer. Contact: anna-stanhewicz@uiowa.edu.
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