States expanding Medicaid coverage of maternity services

• Rising rates of pregnancy related deaths, especially in Black and Native American communities, have drawn more attention to the patchwork of maternal health standards.

What they're saying: More than half of states have taken recent steps toward lengthening the postpartum coverage period beyond 60 days, including some states that haven't opted to extend Medicaid benefits to all adults under the Affordable Care Act.

• More than half the states cover home births under Medicaid — an option that's gained more attention during the COVID-19 pandemic.
• Coverage for services outside of medical settings is mixed, with most states paying for home visits but limiting coverage for educational classes and home-base lactation consultations.
• Very few states offer any coverage for fertility assistance services.
• 11 states are considering adding doula services as a covered benefit. 
• Eight states have initiatives to address substance use or mental health services for pregnant or postpartum beneficiaries.

The findings cover 41 states and the District of Columbia and address benefits implemented as of July 1, 2021.