Now". >> Wisconsin faces a
maternal health care crossroads. While the state
Senate just passed a bill to extend postpartum Medicaid
coverage from 60 days to a full year. The Assembly's
history of stalling the measure leaves thousands of
new mothers in limbo. “Here& Now” reporter Aditi Debnath
has the story. >> With my daughter, I had
really bad postpartum depression and it was a
struggle. >> Wendy Yuen is not alone
in Wisconsin. Two out of every five mothers give
birth on Medicaid. That's the program that provides
health coverage to low income people. Most states
expanded Medicaid to cover postpartum mothers for a
year in Wisconsin, mothers lose coverage just two
months after delivery. For many, that means no support.
During a time of immense physical and emotional
change. >> I was on leave when I
realized that it was really bad. So at that time I was
only making 60% of my pay and I could barely afford to
pay my mortgage and just be able to take care of my son
and the new baby and myself. >> Any expansion to Medicaid
is highly likely in any given area or state to
improve access that women have to prenatal care,
intrapartum care, and postpartum care.
>> Doctor Ryan Spencer is an ob gyn at the UW-Madison
Medical School. He says the state is in a maternal
health care crisis, in part due to years without
Medicaid expansion. >> I think we're actually in
the long term impacts of having not addressed those
for decades. >> The state Senate's recent
vote to extend postpartum Medicaid coverage to a year
aims to address the need for care. The bill, passed with
support from nearly every lawmaker, signaling rare
bipartisan agreement on the issue.
>> I think everyone else gets it. Anyone who's had
kids or anybody who's been around kids knows that the
more that you can have that person to person attention
and frankly, take things off the plate of that parent,
the better. >> But the Senate's vote
contrasts sharply with Assembly Speaker Robin Vos.
Repeated blocks, he said ahead of the Senate vote.
>> My position has been fairly clear from the very
beginning. I've never supported an expansion of
welfare. I can't imagine that I would ever support
one, but we have to talk about it as a caucus that
everybody else is. Snyder, who introduced the
postpartum coverage bill in the Assembly, stresses that
this is not a partisan issue.
>> I've told some of the opponents saying that if a
mom dies a lot of times, that might mean the child
has to go into foster care or, you know, things to that
nature that's going to cost the state more than if we
just help the moms, if they need the help. So, you know,
you got to sometimes talk to them about dollars and
cents. >> Wisconsin is now one of
two states in the nation without a full year of
postpartum Medicaid coverage.
that's covered under state insurance isn't really
enough. Like my daughter's one. And I'm still
struggling every day just to, like, keep up with all
the things that I have to do to make sure that she's
healthy. >> The challenge is even
greater for mothers living outside Wisconsin's larger
cities. Only about half of rural hospitals in the state
offer labor and delivery services. Many of those
mothers are on Medicaid, which reimburses hospitals
significantly less for services.
>> Increasing the reimbursement for obstetric
care would undoubtedly increase opportunities for
hospital systems to run effectively.
>> Availability of obstetric services in rural areas has
gone down for more than a decade, according to the
U.S. Government Accountability Office. It is
difficult for hospitals in rural areas to recruit and
retain maternal health providers. Also, a higher
proportion of rural patients rely on Medicaid, which
doesn't fully cover obstetric services. The
recent end of birthing services at a rural hospital
in northern Wisconsin makes accessing care more
difficult. When Theta Care announced it would close its
Waupaca birthing unit, the Common Council unanimously
passed a resolution asking it to reconsider. For its
part, Theta Care said the needs and demands of
expectant mothers are shifting. Deliveries have
been declining and mothers are choosing to deliver at
larger birth centers. The shortage of physicians and
nurses in rural areas is an issue being felt across the
country and in our region, as labor and delivery
complexity is increasing. >> What you see when you
lose a birthing center for a community. Increased number
of births outside of hospitals. You see an
increased number of preterm births when you lose a
birthing center as well, you lose the opportunity to get
easy access to prenatal care and postpartum care because
you don't have those particular clinicians in
that area anymore. >> The nearest full service
hospital is now 30 miles away in Stevens Point. That
distance can make a difference in a labor and
delivery emergency. The Theta Care Hospital in
Waupaca still provides postpartum and prenatal
care. >> Let's extend postpartum
coverage for pregnant women on Badgercare up to one year
after giving birth. >> Governor Evers has once
again included the postpartum Medicaid
extension in his 2025 2027 budget proposal, alongside
more than $18 million over the next two years to
increase Medicaid reimbursement rates for
obstetric services. >> There's also a bipartisan
bill to get it done that almost 90 legislators
support. >> With the budget debate
heating up, Doctor Spencer warns that without action,
more birthing units will close and more mothers will
fall through the cracks. >> We know that there is
something going on related to the health, wellbeing and
mortality of women giving birth in rural areas that
for some reason is not experienced in urban areas.
The CDC has told us your zip code matters as to how risky
pregnancy is for you, and we need to pay attention to
that. that.