The hearings on Senate Bill 58 have been, to put it lightly, distressing.
The legislation, which passed the Legislature on Wednesday, would extend a full year of postpartum health coverage under Medicaid to mothers and their children for a year, up from the 60 days currently allowed and to a larger number of families. The reason behind the push is Alaska’s mortality rates for mothers and children have been steadily growing over the last decade, growing by two-thirds for women in urban areas between 2012 and 2021 and nearly 200% for women in rural Alaska.
Public health officials told committees that a vast majority of the 57 pregnancy-associated deaths they reviewed between 2016 and 2022 were preventable. A large number of the cases were pinned on the lack of access to health care that could identify and treat issues before they become deadly. Alaska Chief Medical Officer Dr. Anne Zinke told the House Health and Social Services Committee earlier this year that the treatment of women after birth is continuing to evolve to better identify and treat problems as they develop.
“It’s not that everything is completely done and over with after two months or 60 days, it clearly extends beyond that coverage,” she told the committee. “Our threshold as clinicians has changed over time to think about that broader range.”
She also said the coverage can be particularly meaningful to women struggling with alcohol or drug use disorders, relaying a story about a woman who was able to treatment and make meaningful strides toward becoming healthier.
The legislation seeks to extend Medicaid coverage for women from 60 days to one year postpartum, the maximum allowable under recent changes to federal law. Thanks to an amendment in committee by Fairbanks Republican Rep. Will Stapp, the legislation also raises the ceiling on eligibility from 200% of the federal poverty level to 225%, which is estimated to cover an additional 450 births a year.
During the floor debate on Wednesday, Stapp said they believe it will mean a majority of mothers and their children are eligible for such coverage.
“51% of new mothers fall under the category of this bill currently. When mothers are covered by health insurance, we see a 25% increase in child wellness and that looks to increase under the passage of this bill,” he said. “Over the last few years, the state of Alaska has seen an alarming increase in mortality rates among pregnant women. … This bill is one of the most valuable and impactful things we can do for pregnant moms in this state.”
The legislation passed the Senate earlier this year on a 16-0 vote and passed the House on Wednesday with a 35-3 vote—far-right GOP Reps. Sarah Vance, Ben Carpenter and David Eastman were the Legislature’s lone votes against the measure. It now heads back to the Senate for a concurrence vote before it can be sent along to Gov. Mike Dunleavy, whose administration introduced the legislation, to be signed into law.
The extended coverage is contingent on federal approval of a waiver and is expected to come online sometime in 2024.
Matt Acuña Buxton is a long-time political reporter who has written for the Fairbanks Daily News-Miner and The Midnight Sun political blog. He also authors the daily politics newsletter, The Alaska Memo, and can frequently be found live-tweeting public meetings on Twitter.
