ENGROSSED SECOND SUBSTITUTE SENATE BILL 6128

BySenate Ways & Means (originally sponsored by Senators Randall, Darneille, Dhingra, Frockt, Hasegawa, Hunt, Kuderer, Lovelett, Salomon, Stanford, Van De Wege, Nguyen, and Wilson, C.)

AN ACT Relating to improving maternal health outcomes by extending coverage during the postpartum period; adding new sections to chapter 74.09 RCW; creating new sections; providing a contingent effective date; and providing a contingent expiration date.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

(2) Maternal mortality data reveal significant racial and ethnic disparities. In this state, American Indian and Alaska native women are six to seven times as likely to die from a pregnancy-related cause than white women.

(3) The centers for disease control and prevention define the postpartum period as extending one year after the end of pregnancy, and data show that health needs continue during that entire year. In Washington, nearly one-third of all pregnancy-related deaths and the majority of suicides and accidental overdoses occurred between forty-three and three hundred sixty-five days postpartum.

(4) The maternal mortality review panel has identified access to health care services and gaps in continuity of care, especially during the postpartum period, as factors that contribute to preventable pregnancy-related deaths. In their October 2019 report to the legislature, the panel recommended ensuring funding and access to postpartum care and support through the first year after pregnancy.

(5) Postpartum medicaid coverage currently ends sixty days after pregnancy, creating an unsafe gap in coverage. Continuity of care is critical during this vulnerable time, and uninterrupted health insurance provides birthing parents with access to stable and consistent care. Extending health care coverage through the first year postpartum is one of the best tools for increasing access to care and improving maternal and infant health.

(6) The legislature therefore intends to extend health care coverage from sixty days to twelve months postpartum. Nothing in this act is intended to limit eligibility or reduce benefits that are available to pregnant or postpartum persons as of the effective date of this section.

NEW SECTION.  Sec. 2. A new section is added to chapter 74.09 RCW to read as follows:

(1) Beginning January 1, 2021, the authority must provide health care coverage to eligible postpartum persons within the period of time described in subsection (2) of this section. To ensure continuity of care and maximize the efficiency of the program, the amount, scope, and duration of health care services provided to individuals under this section must be the same as that provided to pregnant and postpartum persons under medical assistance, as defined in RCW 74.09.520.

(2) Health care coverage under this section must be provided:

(a) Beginning the first day of the month that follows the month in which the sixty-day postpartum period ends, but in no case earlier than the effective date of this section; and

(b) Ending the last day of the month in which the twelve-month postpartum period ends.

(3) For purposes of this section, the following terms have the meanings indicated unless the context clearly requires otherwise.

(a) "Eligible postpartum persons" means postpartum persons who reside in Washington state, are not otherwise eligible for full scope coverage under Title XIX or Title XXI of the federal social security act, and:

(i) For state fiscal year 2021, have countable income equal to or below one hundred fifty percent of the federal poverty level;

(ii) For state fiscal year 2022, have countable income equal to or below one hundred sixty-five percent of the federal poverty level;

(iii) For state fiscal year 2023, have countable income equal to or below one hundred eighty percent of the federal poverty level;

(iv) Beginning state fiscal year 2024, have countable income equal to or below one hundred ninety-three percent of the federal poverty level.

(b) "Postpartum period" means the period of time that begins on the last day of the pregnancy and ends twelve months after the last day of pregnancy.

NEW SECTION.  Sec. 3. A new section is added to chapter 74.09 RCW to read as follows:

The authority shall provide health care coverage to all postpartum persons who reside in Washington state, have countable income equal to or below one hundred ninety-three percent of the federal poverty level, and are not otherwise eligible for full scope coverage under Title XIX or Title XXI of the federal social security act. Health care coverage under this section must be provided during the twelve-month period beginning on the last day of the pregnancy. To ensure continuity of care and maximize the efficiency of the program, the amount, scope, and duration of health care services provided to individuals under this section must be the same as that provided to pregnant and postpartum persons under medical assistance, as defined in RCW 74.09.520.

(2) Section 2 of this act expires on the date section 3 of this act takes effect.

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