The Health Care Authority (HCA) administers Washington's Apple Health program providing medical assistance primarily through Medicaid. Apple Health offers eligible families, children under age 19, low-income adults, certain disabled individuals, and pregnant individuals a complete medical benefits package.
 
Apple Health provides coverage to pregnant individuals and postpartum persons with countable income at or below 193 percent of the federal poverty level, regardless of citizenship or immigration status.  Once an individual is enrolled in Apple Health coverage and is pregnant, the coverage automatically transitions to After-Pregnancy Coverage (APC) once the pregnancy ends. Individuals receive this postpartum coverage regardless of any income changes and how the pregnancy ends. 

Maternity Core Set. The Centers for Medicare and Medicaid Services (CMS) identified a core set of nine measures for reporting by state Medicaid and Children's Health Insurance Program (CHIP) which is identified as the Maternity Core Set, and it is used by CMS to measure and evaluate progress toward improvement of maternal and perinatal health in Medicaid and CHIP.

The Maternity Core Set consists of six measures from the Child Core Set and three measures from the Adult Core Set. Beginning in 2024, states are required to collect and report on the six maternal and perinatal health measures included in the Child Core Set. The Maternity Core Set measures are:
 
Child Core Set:
    ? live births weighing less than 2500 grams;
    ? well-child visits in the first 30 months of life;
    ? prenatal and postpartum care?under age 21;
    ? contraceptive care?postpartum women ages 15 to 20;
    ? contraceptive care?all  women ages 15 to 20; and
    ? low-risk cesarean delivery.

Adult Core Set: 
    ? prenatal and postpartum care?age 21 and older;
    ? contraceptive care?postpartum women ages 21 to 44; and
    ? contraceptive care?all women ages 21 to 44.

Beginning January 1, 2025, HCA must collect data and report on all of the quality measures related to maternal and perinatal health that are identified by CMS as the Maternity Core Set. 

By June 30, 2026, and annually thereafter, HCA must publish the collected data, provide comparative data to the previous year detailing any progress made in improving outcomes, and provide information detailing any steps taken to improve outcomes. HCA must make this report publicly available on its website.

PRO: This data is already being collected and the compiled information should be available for the public to access on the website. This bill is an opportunity to see how the state is doing and whether the state is succeeding in the efforts related to maternal health and infant mortality or if there are areas that need more focus.

OTHER: The agency is planning on collecting data on all nine of the measures. Of those measures, seven of them are already getting reported to CMS. CMS does its own analysis around a few of those measures using state-reported data. To the extent, the Legislature has interest in having the data available for policy decisions and available to the public, there is an added value for the state. Some resources will be needed for the agency to implement the bill.