OHA extends Medicaid coverage after childbirth under OHP

Oregonians under OHP are eligible for extended postpartum coverage. This includes the necessary physical, dental, vision and behavioral care.

Salem, Oregon. Oregonians in Medicaid coverage who deliver and their babies are now eligible for 12 months of medically necessary physical, dental, vision, and behavioral care through the state’s health care plan.

Eligible women to cover through Oregon Health Plan Because of their pregnancy status they were previously limited to 60 days postpartum. The change entered retroactively in April after Oregon Health Authority (OHA) Received federal approval from the US Department of Health and Human Services to extend benefits for 12 months after giving birth.

Just over 40% of births in the United States are under Medicaid. It’s at least that high in Oregon, Patrick Allen, director of the OHA, said during the June Oregon Health Policy Board meeting.

The postpartum period is a critical time for both parents and infants, including physical recovery, breastfeeding support, mental health struggles, and managing health conditions that can be amplified through pregnancy.

The extension of postpartum care aims to advance the OHA’s goal of eliminating healthcare inequality by 2030.

a Report Published by HHS Office of the Assistant Secretary for Planning and Evaluation show that pregnancy-related deaths are two to three times higher among the non-Hispanic black and American Indian/Alaska Native populations than in the white population.

The report states that one in three pregnancy-related deaths occurs within the first year after birth.

How do I get help

There is no need to enroll in a new program to receive an extension of care; Those on an Oregon health plan will automatically get extended coverage if they qualify while pregnant.

Lise Garst, OHA’s health policy communications officer, said medical providers have been notified of what coverage might include.

This extension of care includes adding more strong vision and dental care for pregnant women, which is usually more limited, explained Erin Fair Taylor, vice president of Medicaid programs at PacificSource Health Plans.

Taylor emphasized the importance of communication with service providers and OHP users. She said anyone who needs help navigating the health care system can call PacificSource at 888-977-9299 for help understanding the care available to them, finding providers that accept OHP, and any other health navigation questions.

“We don’t want anyone struggling alone,” Taylor said. “We are here to help.”

Support is still needed at home

Salem’s mom, Araceli Navarrete, understands postpartum struggles.

After a difficult labor and birth about three years ago, which required two blood transfusions, Navarrete struggled with fatigue and mental health, all while trying to care for a newborn.

“I needed to continue to heal myself, I found it very difficult both physically and mentally to take care of my child,” Navarrett said.

After extreme exhaustion, Navarrete also struggled to breastfeed.

“Looking back now, I wish there was some kind of support for new moms who could be of help around the house,” Navarrett said.

12-month postpartum OHP coverage does not provide in-home support.

Navarrete expressed how helpful it was to get help during the day for her. She had the support of her mother and stepfather outside of work hours, but she would take care of her daughter alone during the day.

“We need to nurture our new mothers if we want to provide a strong foundation for the health and happiness of these young children,” Navarrett said. “If my mom is sick and unsupported, the baby will be fine, too.”

There is a lack of care for Doula

Medical providers can recommend Doula care to patients who struggle to care for themselves and their children, but PacificSource only supports 15 hours of Doula care using flexible funds.

There is also a shortage of doulas, who provide non-clinical support at home in any way a client may need, said Annie Williams, a postpartum officer for the Northwest Doulas District in Salem.

“We turn down OHP clients every day because we don’t have enough doulas,” Willems said.

Additionally, finding a culturally aware country that can speak the customer’s first language can be a barrier.

“We can tell the client we have all that support, but it doesn’t help if we don’t speak their language,” Willems said.

She said her office gets a lot of calls from people who struggle to get appointments with their obstetrician or primary care doctor and are looking for some kind of support.

Local mothers ‘no help’ after giving birth

Many other local mothers shared their postpartum struggles.

Katrina Rivera of Keizer said it was hard to find dental clinics that accept OHP and they weren’t fully booked.

Albany’s mother, Mackenzie Kay, suffered from PTSD after giving birth and had difficulty refilling her medication while awaiting ongoing OHP coverage.

Kay said she’s pleaded with her doctor and pharmacist, but was still unable to refill the medication.

“I had to pay them out of my pocket, which I didn’t have money for, so I suddenly stopped taking them instead,” Kay said.

“I was so lost and didn’t get help,” she said.

Julia Reagan of Salem struggled with postpartum depression and postpartum illness. Reagan said she had to turn to other local mothers and the community around her for support at six months after giving birth.

“I hope these stories draw attention to the postpartum period and how important it is to get these mamas to help when they need it,” Reagan said.

Sydney White covers healthcare inequality in the Mid Willamette Valley for the Statesman Journal. You can contact her at SWyatt@gannett.com, by phone (503) 399-6613, or on Twitter @sydney_elise44

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