Bi-partisan cooperation in the Missouri legislature crafted to reduce the state’s maternal mortality rate is now jeopardized by a handful of right-wing Republicans, several from the St. Louis area.
The original versions of Senate Bills 45 and 90, sponsored by state Sens. Elaine Gannon, R-De Soto, and Tracy McCreery, D-Olivette, had garnered support from both Democratic and GOP representatives. However, members of the chamber’s “conservative caucus” added amendments that likely render the legislation useless because the bills violate federal rules.
Before being altered, the bi-partisan bills extended postpartum MO HealthNet benefits to one year after giving birth, a significant increase from its current period of just two months.
The Republican actions would leave just under 4,600 Missouri women without benefits and preventative care during a crucial period after pregnancy that sees the highest rates of maternal death.
On Tuesday, the House Emerging Issues committee passed a version of the bill without the problematic language Tuesday afternoon. It combined language from Democratic state Rep. LaKeySha Bosley and Republican Reps. Brad Pollitt, Melanie Stinnett and Bishop Davidson.
Bosley said the bill was vital because Missouri has the seventh highest rate of maternal mortality in the United States, and Black women are four times more likely to die during childbirth than white women in the state.
“Extending postpartum coverage and access to care has proven to lower the rate of maternal mortality,” Bosley, D-St. Louis, said.
“Passing this incredibly simple language out of the House — without any changes — will save lives and make it so fewer babies lose their mothers in that first year of their lives.”
According to a 2022 report on pregnancy-associated mortality from the Department of Health and Senior Services, an average of 61 women across the state died from 2017 to 2019 while pregnant or within one year of being pregnant. The report also found that most of those deaths — roughly 75 percent — were preventable, and the greatest proportion of those deaths occurred between 43 days and one year after birth.
As a result of these findings, the report recommended that the legislature should “extend Medicaid coverage to one year postpartum for all conditions… to aid women whose condition is exacerbated in the postpartum period.”
Gov. Mike Parson even made it a top priority in his State of the State speech in January.
State Rep. Patty Lewis, D-Kansas City, who also had a bill heard in committee that would extend postpartum benefits, sees a path forward for this language — unimpeded by potentially damaging amendments.
“We know that the governor, DHSS and most lawmakers approve extending these benefits without strings attached, so we have to do our due diligence in the House to keep this legislation clean,” Lewis said.
“We know we cannot solve every problem in our state with the flip of a switch, but providing these benefits during this time frame will go a long way to saving the lives of Missouri mothers.”
Bosley’s bill is House Bill 957 (now combined with HBs 254, 354 and 965), and Lewis’ bill is House Bill 286.
Other states have tried to be clever with this and have not been able to get these customized state plan amendments through,” McCreery told Missouri Independent.
“So I just don’t want to do anything that jeopardizes the bill.”
Michelle Trupiano, executive director at Missouri Family Health Council, a nonprofit that advocates for health care access, said she is concerned the new language threatens the goal of postpartum extension because the federal government has “made it very clear that they need clean legislation” to authorize a state plan.
“We are very disappointed that once again, political ideology by a few members of the Senate is standing in the way of making that bipartisan, full support for postpartum folks happen,” Trupiano said.
A proposal to extend postpartum Medicaid coverage was close to gaining approval from the legislature last year, but narrowly failed as a group of Republican senators blocked a version of the legislation.
Joan Alker, executive director of Georgetown’s Center for Children and Families, called the focus on abortion a “solution in search of a problem.”
“If Missouri legislators are sincere and want to address the needs of postpartum women they should do what the majority of states are doing and stick to the standard language,” Alker said.
