Oklahoma women now have access to expanded pregnancy and postpartum SoonerCare coverage after the Center for Medicare and Medicaid Services (CMS) approved Oklahoma’s state plan amendment today. With this approval, Oklahoma’s income threshold for full-scope pregnancy-related benefits will increase from 138% to 205% of the federal poverty level (FPL) and will provide new mothers with 12 months of continuous postpartum coverage instead of the previous 60 days of coverage.
"As governor, my vision is to make Oklahoma a Top Ten state in everything we do, including health care outcomes, so ensuring more women have access to better, longer care is a positive step in the right direction for our state," said Gov. Stitt.
The additional services include postpartum care, prescription drugs, genetic testing, vision and hearing services to treat disease, physical, occupational, and speech therapies, preventive primary care, and more robust dental benefits during and after their pregnancy.
"This expanded coverage will allow thousands of Oklahoma women to have access to services to reduce risk and create additional opportunities for better health outcomes," said Kevin Corbett, Secretary of Health and Mental Health Services and CEO of the Oklahoma Health Care Authority. "Oklahoma is on a health care transformation journey, and this step will ensure women have access to quality care."
With the increased income threshold, OHCA estimates 2,500 SoonerCare members in the current eligibility group will transition to full-scope pregnancy benefits and maintain coverage through the postpartum period and up to an additional 14,000 Oklahoma women will be eligible for SoonerCare for a full year after pregnancy.
Oklahoma is the 30th state to be approved by CMS for extended coverage through President Biden’s American Rescue Plan (APR) and made permanent by the Consolidated Appropriations Act, 2023 (CAA, 2023).
One-third of maternal deaths occur in the postpartum period, including up to 1 year after childbirth. Almost 12% occur past the six-week postpartum visit. More than half of these deaths are preventable and often related to chronic conditions such as diabetes, hypertension, mental illness and substance misuse. Further, postpartum depression affects one in nine new mothers with 40-60% of low-income new mothers reporting depressive symptoms.
"Access to more health care services for pregnant postpartum women is vital to better health outcomes for mother and child," said State Medicaid Director Traylor Rains. "With this expanded coverage, we can work to help these new mothers and their children have a healthy start to their lives."
The CMS approval comes after Governor Kevin Stitt’s Helping Every Life and Parent (H.E.L.P.) Task Force unanimously recommended OHCA expand pregnancy and postpartum services for SoonerCare members. Governor Kevin Stitt created the task force to study, evaluate, and make recommendations regarding policies, programs, and proposed legislation to support crisis pregnancy centers, make adoption easier, support mothers facing an unplanned pregnancy and empower nonprofit organizations and local faith communities to support families and mothers before, during and after childbirth.
Learn more about the expanded coverages at oklahoma.gov/ohca/individuals/programs/pregnancy-services.html.