Postpartum Medicaid Coverage & FMLA: Birth and Miscarriage Update

Did you know that Medicaid pays for nearly 50 percent of U.S. births? It does—and the Affordable Care Act sets minimum standards for preventive care (see below).

Texas Democrats have introduced a bill to expand postpartum Medicaid coverage after a woman gives birth or miscarries. Currently, the benefit is 60 days. Democrats want the eligibility to extend to 12 months.

For comparison of state coverage, click on this map:

The Texas legislation would not cost employers directly. But an employee who has given birth or miscarried may be more likely to take time off of work and invoke the Family and Medical Leave Act. This would also bring up issues surrounding job protection under the FMLA, as well as Medicaid work requirements.

Table 3: Preventive Services for Pregnant Women Required for Coverage under ACA Medicaid Expansion

Anemia screening on a routine basis for pregnant women

Bacteriuria urinary tract or other infection for pregnant women

Breastfeeding comprehensive support and counseling from trained providers, as well as access to breastfeeding supplies including pumps, for pregnant and nursing women

Depression Screening for all adults, including pregnant and postpartum women

Folic Acid supplements for women who may become pregnant

Gestational diabetes screening for women 24-28 weeks pregnant and those at high risk of developing gestational diabetes

Hepatitis B screening for pregnant women at their first prenatal visit

HIV screening for all pregnant women, including those in labor who are untested or with unknown HIV Status

Rh Incompatibility screening for all pregnant women, and follow-testing for women at higher risk

Tobacco use screening and interventions for all women, and expanded for pregnant tobacco users

Syphilis screening for all pregnant women and other women at increased risk

SOURCE: HHS, Preventive Services Covered Under the Affordable Care Act, September 27, 2012

Source: Kaiser Family Foundation, https://www.kff.org/report-section/medicaid-coverage-of-pregnancy-and-perinatal-benefits-introduction/