New mothers in Wyoming enrolled in the Medicaid Pregnant Women Program lose their health insurance 60 days after giving birth, but a new bill making its way through the state's 67th Legislature would extend coverage for a full year.

Marissa Carpio, policy associate for the Wyoming Women's Foundation, said having health insurance is the number one determinant of good health, for mothers and newborns.

"Having health insurance means that you're more likely to seek preventive care, or get that odd symptom checked out that maybe arose during birth or after birth," Carpio observed. "And to not have to sacrifice the funds for your food or your rent to go figure out those health complications."

House Bill 4, sponsored by the Joint Labor, Health and Social Services Interim Committee, is now on General File and could get its first vote today.

Some critics have argued expanding coverage for new mothers is unnecessary because assistance is already available through Medicaid's Family Planning program. Newborns remain eligible for health insurance during their first year.

Carpio pointed out the family planning program is not comprehensive, it only covers gynecological exams and lab tests. It does not cover health issues including heart disease or stroke, which are leading causes of death for new mothers.

Working women of childbearing age are currently the largest group in Wyoming without insurance, largely because they are less likely to get coverage through their employer.

"They're more likely to be working part-time, low-paying jobs that don't offer insurance anyway," Carpio noted. "This type of program that is so specific to new mothers in our state is very important for the success of babies and communities."

According to the Wyoming Department of Health, nearly one in five new mothers participating in the Medicaid Pregnant Women Program currently end up losing health insurance.

Carpio believes healing after birth is a long and important process, and access to care will help women avoid financial and health-related stress, return to work and attain economic self-sufficiency.

"The biggest and most important thing is that continuous coverage after birth," Carpio emphasized. "When you're trying to raise a newborn child, trying to get back to work, the last thing you want to do is try to get your health insurance back to go see the doctor. You should be able to see the doctor when your family needs to."

Wisconsin policymakers have less than a month to adopt a new state budget. Advocates for extending postpartum health coverage through Medicaid hope it winds up in the final spending plan.

Through the American Rescue Plan, states have the option to extend Medicaid coverage for new mothers for up to a year after they give birth. To receive matching federal funds, states have to create their own program for this benefit.

Dr. Jennifer Krupp, maternal-fetal medicine specialist at SSM Health, said the current 60-day coverage window puts too many new mothers at risk for serious medical complications - such as hypertension disorder.

"When we only see them for two months, because that's all the coverage they have," said Krupp, "we really can't make sure all of their needs are being met to control their blood pressure."

She said depression is another chronic problem that could affect outcomes for both the mother and child if left untreated.

That's because the condition limits the mother to tend to her health needs, while impacting her bonding with her newborn.

The proposed Wisconsin extension has bipartisan support, but it's unclear if it will be included in the Department of Human Services section of the budget.

Annmae Minichiello is a UW Health pharmacist and American Heart Association volunteer. She said the issue is near and dear to her, because she developed a rare form of heart failure after the birth of her daughter.

She said she was lucky to have health coverage, noting the lengthy follow-up that was needed to avoid a dire outcome.

"I had to have several echocardiograms for months and years - and annually still, even though this incident happened about six years ago," said Minichiello. "So, if I didn't have that follow-up, it could be very fatal."

Her experience inspired her to speak up for women who need that extended coverage so that more lives can be saved.

Efforts such as this come amid recent Centers for Disease Control and Prevention data showing alarming trends when it comes to the nation's maternal mortality rate. The rates have grown considerably higher for Black women.

Breast cancer is the leading cause of cancer death in Utah women.

According to the Utah Women and Leadership Project at Utah State University, Utah is among the three lowest-ranked states in the country for mammography screening rates in women aged 40 or older. According to the group, The Utah Department of Health and Human Services was unable to meet its goal of 76% of Utah women, aged 40 years and older, to be screened for breast cancer in 2020.

Chloe Bhowmick, clinical psychologist and research fellow for the Utah Women and Leadership Project, said a lot of the challenges inhibiting mammography rates are "financial and systemic."

"Having lack of insurance, not having insurance coverage through their job, not being able to get time off," Bhowmick outlined. "Those are all, I think, pretty important factors that we found or at least we surmised in being pretty significant."

Bhowmick noted other factors which have negatively affected screening rates include lack of affordable child care, discrepancies between mammography guidelines as well as varying levels of health literacy. Only 62.7% of Utah women aged 40 years and older reported having a mammogram in the last two years. The national average for U.S. women in the same group was 69%.

Bhowmick emphasized it is also important to not forget because of the COVID-19 pandemic, medical centers are still catching up on the backlog of mammography appointments, which can further delay preventive services.

Bhowmick added while the Beehive State is currently sitting 6.3% below the national average, local and state systems can take steps to increase screening rates, including having insurance systems building patient advisories into electronic record systems, tracking how often providers remind individuals of preventive care and employers implementing initiatives such as wellness programs and policies.

"I think having systems that support women, women will be able to both realize that this should be a priority with certain age groups, but also they have the freedom to go," Bhowmick explained.

The Utah Department of Health and Human Services has a goal of 81% of age-eligible Utah women receiving a mammogram by 2030. Bhowmick stressed education and advocacy from community groups can help the state reach its goal.


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To wrap up Women's Health Week, doctors are urging women to take stock of their mental health.

Dr. Sharon Eloranta, medical director at the Washington Health Alliance, said COVID-19 was hard for everyone and led to a drop in health screenings.

She said with the worst of the pandemic over, some women may need to consider how to prioritize their health.

"Women experienced more anxiety and stress during the time of the pandemic," said Eloranta, "and I think that may have been reflective of the fact that they worry not only about their own health, but about health of the people in their families and others. And that can be a hill to climb if you're trying to get back into taking good care of yourself."

For Women's Health Week - which runs through Saturday - the Centers for Disease Control and Prevention is asking women to schedule regular checkups, exercise and eat a healthy and balanced diet.

CDC data show a disturbing trend in mental health, with the rate of young girls saying they attempted suicide twice that of young boys.

Dr. Donna O'Shea, an OB/GYN and chief medical officer of Population Health at UnitedHealthcare, said parents need to be on the lookout for symptoms of depression and anxiety in adolescent girls.

"Especially after COVID," said O'Shea. "We found that 57% of high school girls have experienced persistent feelings of sadness in the last year. Ten years ago, that number was only 36%."

Eloranta said it's important for people to pay attention when they aren't feeling normal.

"'I'm just down, and nothing that usually makes me happy tends to change it.' Then that's time to reach out and try and find some support," said Eloranta. "And again, it can be through your employer, it can be through your primary care. You can always call a friend and see if they have any referrals for you to go and get some assistance."