In 2020, U.S. maternal mortality reached a strikingly high rate, disproportionately affecting people of color and hitting tallies more than double those of other developed countries. These numbers, and related issues of maternal health, became talking points for then-candidate Joe Biden during his 2020 presidential campaign, when he promised to "reduce our unacceptably high maternal mortality rate."
We decided to check the progress on this promise about two years into his presidency.
In general, maternal health experts told us that the administration's focus on advocacy, expanding health coverage, and advancing data collection are significant steps toward making good on his pledge.
"The current administration is supporting and advancing maternal health in a completely unprecedented, comprehensive way," said Carol Sakala, the National Partnership for Women & Families' director for maternal health.
The key piece of evidence experts pointed to is the White House Blueprint for Addressing the Maternal Health Crisis. The document, unveiled by the Biden administration in June, included policy proposals such as expanding Medicaid's required postpartum coverage to at least 12 months and conducting more maternal health research. It also advanced new initiatives to diversify the workforce involved in treating patients while they are pregnant and after they give birth, and investments to address geographic, racial, and ethnic disparities in care.
The administration's push for Congress and the states to extend Medicaid's postpartum coverage to 12 months — with either the passage of federal legislation or the approval of state Medicaid waivers, or both — is critical to making good on this promise, experts said.
Historically, the Medicaid program sets the minimum eligibility for this coverage at 60 days after giving birth, though 53% of maternal deaths happen a week to a year after pregnancy, according to the Centers for Disease Control and Prevention.
The American Rescue Plan Act, which Biden signed into law in 2021, included a provision giving states the option to extend Medicaid postpartum coverage to 12 months. That provision was scheduled to expire in five years, but the option was then made permanent — though the coverage change was not mandated — in the 2022 year-end omnibus bill.
Experts also said the administration's goal of providing more comprehensive Medicaid coverage for all stages of pre- and postnatal care, and postpartum services would help address racial and ethnic disparities.
"It's the emphasis that it takes a team," said Dr. Gloria Bachmann, OB-GYN clinical leader at the American Medical Women's Association and a professor of OB-GYN at Rutgers Robert Wood Johnson Medical School.
But none of the Biden administration efforts are fast fixes, especially when it comes to stepping up research and data collection — which have significant roles in improving the nation's maternal health infrastructure.
"It's really something to get started for the long haul," said Dr. Theresa Rohr-Kirchgraber, president of the American Medical Women's Association.
We rate this promise In the Works.