A MARTÍNEZ, HOST:
Maternal health advocates say women should have continuous health coverage for a year after they give birth. Every state but one has moved to expand postpartum Medicaid coverage. That one state that has not is Arkansas. Sarah Varney, with our partner KFF Health News, spoke with one new mother there whose care fell into a coverage gap.
SARAH VARNEY: In the last few months, Maya Gobara's life has revolved around the neonatal intensive care unit in Little Rock. Her preemie twins, Amir and Bryson, are on breathing tubes and have needed multiple brain surgeries. Trouble with her Medicaid coverage started six weeks after she had an emergency cesarian section.
MAYA GOBARA: I was getting a prescription filled and the pharmacy told me that I didn't have insurance.
VARNEY: The plan she had been on all through her pregnancy and for six weeks after the twins were born had been terminated, and she was moved without notice to another program with different doctors. All of this happened to Maya, who is 38 and a freelance copywriter, just as a cascade of previous health problems flared back up.
GOBARA: Everything that I had before just kind of hit me like a ton of bricks at once after I had the boys.
VARNEY: An autoimmune disorder, postpartum depression and rheumatoid arthritis. And she was seized by gallbladder pain.
GOBARA: I was supposed to have my gallbladder taken out in one week, but with this new plan, I needed a referral for that surgery. But I no longer could see my primary care doctor because she wasn't under that plan that they put me under.
VARNEY: Health experts say new mothers shouldn't be shuttled from plan to plan or uninsured when they are dealing with their own health and their newborns. And that thinking is behind the Biden administration's push to encourage states to extend postpartum Medicaid coverage.
Earlier this year, Arkansas Governor Sarah Huckabee Sanders signed an executive order creating a committee of experts charged with improving the state's dismal maternal health outcomes. Arkansas has one of the highest rates of maternal mortality in the nation. At a press conference in March, reporters pressed the governor on whether she planned to expand postpartum Medicaid coverage to 12 months. The answer was a firm no.
(SOUNDBITE OF ARCHIVED RECORDING)
SARAH HUCKABEE SANDERS: I don't believe creating a duplicative program just for the sake of creating a program is actually going to fix the issue. We already have so many women who aren't taking advantage of the coverage that exists. Creating more coverage doesn't get more women to the doctor.
VARNEY: Medicaid pays for more than half of all births in the state and about 40% of all births in the country. Among the voices in Arkansas that disagree with Huckabee Sanders is Camille Richoux.
CAMILLE RICHOUX: Stakeholders, health organizations, our own maternal mortality review committee have all recommended extending postpartum coverage.
VARNEY: Richoux is with the nonprofit advocacy and policy group Arkansas Advocates for Children and Families. She's on the governor's committee and says between 20- to 29% of Arkansas women are uninsured for some time before they conceive and after they give birth. Zenobia Harris says the program the governor is touting is not working. Harris is the executive director of the Arkansas Birthing Project and another member of the governor's committee.
ZENOBIA HARRIS: Women get told things like their paperwork got misplaced or lost or they have to resubmit paperwork. They get put on hold when they make phone calls in trying to connect with people. So some people quit trying.
VARNEY: That was how Maya Gobara, the new mom of the twin preemies in West Little Rock, felt.
GOBARA: It felt like the system was set up so that I would give up. And honestly, if it was not for my mother sitting next to me and helping me go through step by step by step, I probably would have given up.
VARNEY: Maya is covered now. She was finally able to get her gallbladder surgery, and she has an entirely different set of doctors. The final recommendations of the Arkansas committee charged to improve maternal health are expected to be released in September. I'm Sarah Varney.
MARTÍNEZ: Sarah is with our partner KFF Health News. Transcript provided by NPR, Copyright NPR.
NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.