A measure that would extend postpartum Medicaid coverage for new mothers in Wyoming to a year continues to move through the Wyoming Legislature.
Even two Cheyenne high school students who have never been mothers were at the state Capitol on Wednesday lobbying lawmakers to approve House Bill 4. Breathlessly and without showing any nerves, the pair offered firm, confident testimony on the bill.
“Any sort of Medicaid bill that would extend coverage for women or any sort of population that didn’t have enough money to pay for insurance I really wanted to testify (about),” Cheyenne Central High student Gweneth Hargett told Cowboy State Daily.
The Senate Labor, Health and Social Services Committee ultimately passed the bill with a 3-1 vote. It’s already passed through the House.
New Experience
Hargett, a speech and debate student, said testifying for the committee was a little more intimidating than school competitions.
“It was a little more nerve-wracking just because this actually matters … but it was really fun,” Hargett said.
Lily Leman, the other high school student to testify and who also participates in speech, said she was driven to address the committee because she believes there is a negative social perception of people who use Medicaid.
“I think there’s a stigma that if you are on government federal aid that you are just relying on government handouts or that you’re just depending on government, and that’s absolutely not true,” she said, mentioning how her mother was on Medicaid. “A lot of women need that federal aid as, like, a starting point.”
Hargett believes extending postpartum coverage could improve social mobility for the low-income mothers who qualify for the program.
“When you’re using all of that money, you don’t have any other money to essentially invest in your future and a retirement plan or anything like that,” she said. “I think it could honestly be beneficial for the state too, because when you’re seeing less women in emergency room visits, it’s ultimately a lower cost on the state as well.”
State Sen. Fred Baldwin, R-Kemmerer, who chairs the committee, said he was thoroughly impressed by the two girls and their ability to deliver testimony while seemingly never taking a breath or pause.
Low Income Impact
If passed into law, House Bill 4, would increase the length of postpartum Medicaid coverage for new mothers from 60 days to a year. The bill now only needs to make it through the Senate to be advanced to Gov. Mark Gordon, who already has indicated his support for it.
Mothers who make up to 154% of the federal poverty level qualify for postpartum Medicaid coverage.
Hargett mentioned a 2020 study performed by the Health Care Cost Institute that found 81% of postpartum care spending happened after the first 60 days of giving birth. A single mother with one child could not make more than $1,653 per month and qualify for the program.
“This is simply unfeasible for parents that are using Medicaid right now,” she said.
Hargett also mentioned how expansion of coverage could lead to fewer postpartum health complications.
“Problems that arise after postpartum don’t simply arise after an arbitrary 60-day limit,” she said.
Government Dependence
Sen. Lynn Hutchings, R-Cheyenne, was the only member of the committee to oppose the bill.
“I’m not cold-hearted, it’s just that I ran on not entangling myself or our state with the federal government in any way,” she said. “This is another program where we’re going to spend millions getting ourselves tied up with the federal government, not knowing what strings are going to be attached for the future.”
The cost of the extension is $1.9 million, matched dollar-for-dollar by federal money.
Hutchings, who said she was raised by a single mother who tried to get off Medicaid as soon as possible, argued that private nonprofits and other support groups can provide the same help to mothers who would be provided by the bill.
Leman said using this type of logic, one could argue the government should have no involvement of any kind in health care.
“Do we need to tell our veterans that their access to health care should be questioned?” Leman said.
Hargett said most women don’t choose to be on Medicaid, but rather have fallen into that circumstance because of other factors.
Stories Of Depression
Proponents of HB 4 alao spoke to the postpartum depression that Hargett said affects one in every eight new mothers.
“Mothers may stop breastfeeding, have problems bonding with and caring for their infants and be at an increased risk for suicide,” Leman said.
Erin McKinney, a doctor at the Cheyenne Regional Medical Center, was brought to tears reflecting on her own bout with postpartum depression.
She said babies have a decreased connection with their mothers, hampered social skills and other long-term negative outcomes when mothers suffer untreated postpartum depression.
Megan Schuster, a nurse at Cheyenne Regional Medical Center, shared her story of postpartum depression.
Schuster said she was stricken with suicidal thoughts that started about three months after giving birth to her second child, which resulted in her heavily relying on the assistance of her husband and mother to raise her baby boy through his infant years.
Schuster said if she hadn’t had family and health insurance, she’s not confident she would have been able to avoid a tragic outcome.
“It’s not easy to tell someone that you almost killed yourself last night and the night before that,” she said. “It’s way easier to fake it and pretend like you’re doing fine.”
Schuster finished her testimony by showing a photo of her two boys.
“Sometimes I think to myself, ‘How do I tell Finn, my oldest, that he was literally my salvation, that because of him I talked myself out of suicide nearly every day?’” Schuster said. “And how do I tell Kanan, my trusting, independently sweet toddler, that it wasn’t his fault, it was never his fault.
“It wasn’t my fault either. Hormones and brain chemistry are beyond our conscious control.”
If It Passes
In response to the COVID-19 pandemic, the 2020 Families First Coronavirus Response Act temporarily extended postpartum medical benefits to new mothers to one year. Before that in Wyoming, mothers were covered for 60 days.
With the extension, enrollment increased from 1,200 to 4,200 in Wyoming. Around 1,200 to 2,000 mothers a year are expected to benefit from the extension.
The bill would make the postpartum Medicaid extension effective through at least 2024. Legislators would have to determine whether they want to continue funding the program by 2024.
If HB 4 passes, it would likely be the closest to a full Medicaid expansion to pass in Wyoming. Many of the same advocates who pushed for the Medical Treatment Opportunity Act were in the audience on Wednesday. That bill for a wide expansion of Medicaid in Wyoming was not considered in the House and subsequently died.
