Iowa lawmakers unanimously moved forward Monday with the governor’s proposal to extend postpartum Medicaid coverage for new mothers to 12 months.

During the discussion, advocates asked for coverage of a greater income range.

Senate Study Bill 3140 would bump postpartum coverage from its current 60 days to a year, as allowed through the federal COVID-19 emergency plan signed into law by President Joe Biden in 2021. The bill limits qualification for the program to people with family incomes at or below 215 percent of the federal poverty line — a restriction from current Medicaid eligibility for postpartum mothers at 380 percent of the poverty limit.

Denise Rathman with the Iowa chapter of the National Association of Social Workers said the organization was happy to see Iowa join the national program expanding postpartum care, but members were concerned about the more restrictive income requirements for participation. Rathman suggested legislators look at ways to leverage funding through the federal Children’s Health Insurance Program program to expand eligibility for the health care benefits.

“One of the things that I think needs to be the backdrop as we talk about this is we have a maternal mortality crisis,” Rathman said. “We have an infant mortality crisis. This is a single policy lever that you can pull to improve the health of moms and babies.”

There were no lobbyists registered against the legislation, and no one spoke in opposition to the proposal at the subcommittee meeting. Speakers with medical organizations including the Iowa Medical Society and American College of Obstetricians & Gynecologists praised Gov. Kim Reynolds’ office for releasing the proposal, but also asked lawmakers to consider changes to the income requirements.

Molly Severn, legislative liaison for the governor’s office, said the bill’s income requirements would mean coverage for a single mother with an income of $42,000 per year and one child, and coverage for families of four at roughly $64,000 per year. The bill would also put Iowa at the 13th highest income requirements in the nation for pregnant women and infant coverage, she said — in addition to coverage for newborns through the Healthy and Well Kids in Iowa program (Hawk-I) at 302 percent FPL.

Sen. Janet Petersen, D-Des Moines, supported the bill moving out of subcommittee, but questioned the governor’s decision to change income requirements while spending state funds elsewhere. She pointed $25 million dedicated to office space changes for the Department of Health and Human Services.

“I think the ultimate question is, is this the best that Gov. Reynolds can do for pregnant moms in Iowa?” Petersen said.

Sen. Mark Costello, R-Imogene, said there is “validity” to the income requirement concerns, and there could be further discussions on changes to the income requirements. However, Costello said the average FPL coverage is at 210 percent for the 47 states participating in the postpartum Medicaid program — meaning the governor’s proposal is less restrictive than other states.

He also said that under the current FPL rate, a family of four making $112,500 annually would be eligible for Medicaid coverage, saying “that’s pretty good money, and you probably should be able to have insurance or take care of it yourself at that rate.”

“So I think there’s room for us to move that down, and to be in line with other states,” Costello said. “Whether 215 percent is the magic number not, I mean, it seems to be what we think is the break-even number or the budget neutral. So I understand why we came to that.”

Governor’s bill expanding postpartum Medicaid advances