Medicaid Coverage For Maternal Mental Health

Where We Stand

NAMI believes that all people with mental health conditions deserve accessible, affordable, and comprehensive health care. NAMI supports public policies and laws that extend Medicaid coverage for at least 12 months postpartum.

Why We Care

Mental health conditions are common among many women during pregnancy or the postpartum period (after the birth of a child). Postpartum depression and anxiety disorders affect one in seven mothers nationwide, making it the most common complication of pregnancy and childbirth. Yet, national figures show that these conditions often go undiagnosed and untreated: only 50% of women diagnosed with perinatal depression receive treatment. Unfortunately, when left untreated, mental health conditions are one of the leading causes of pregnancy-related death that occur within a year postpartum.

Medicaid is the primary payer of maternity care in the U.S., covering nearly half of all births. Therefore, Medicaid coverage is a critically important way to address maternal mental health and our nation’s rising rate of maternal mortality.

The days and weeks following birth are a vital period for a woman and her infant, setting the stage for long-term health and well-being. However, state Medicaid programs are only required to cover women 60 days after giving birth. Once the 60-day period ends, some women can successfully transition to other sources of insurance, but many are left uninsured.

These gaps in coverage are especially problematic for individuals with serious and chronic health conditions, like mental illness, limiting their access to critical health services and supports. When new mothers lack consistent coverage for care, their mental and physical health suffers, and they are less likely to receive outpatient mental health services.

Additionally, these coverage disruptions disproportionately affect women of color; nearly half of non-Hispanic Black women and 80% of Hispanic women lack continuous insurance coverage from pre-pregnancy to postpartum.

Access to coverage and care is essential for people with mental illness to successfully manage their condition, including pregnant and postpartum women. The American Rescue Plan Act (P.L. 117-2) included a new five-year option that allows states to extend the postpartum period to 12 months. NAMI supports states taking advantage of this, and for the option to be made permanent so that more women have access to mental health care during the critical postpartum period.

How We Talk About It

• Mental health conditions are common during pregnancy or the postpartum period.
• Postpartum depression and anxiety disorders affect one in seven mothers nationwide, making it the most common complication of pregnancy and childbirth.
• Medicaid is critical for addressing the mental health needs of postpartum mothers. Medicaid is the nation’s largest payer of mental health and substance use condition services, and covers nearly half of all births.
• States are only required to provide Medicaid coverage for postpartum women for 60 days, leaving many in search of a new source of coverage or losing coverage entirely. This creates gaps in coverage during a critical period for a new mother and her infant.
• When new mothers lack consistent coverage for care, their mental and physical health suffers. They are also less likely to receive outpatient mental health services at a time when they are at risk of postpartum mental health conditions, which can start any time in the year after childbirth.
• By extending postpartum Medicaid coverage up to 12 months or more, states can ensure that new mothers are receiving regular care for their mental and physical health needs.
• Extending postpartum coverage is also important to reduce health inequities, as pregnancy-related deaths disproportionately impact communities of color.
• NAMI supports efforts to expand Medicaid coverage up to at least 12 months postpartum to support the physical and mental health needs of new mothers.

What We’ve Done

• NAMI February 2021 letter with national partners urging the federal Centers for Medicare and Medicaid Services to approve state proposals aimed at extending postpartum coverage for individuals to a full year after the end of pregnancy.
• NAMI submits comments on individual state proposals to expand Medicaid coverage for postpartum women. These comments are available by request.