ACE

Tag: Pregnancy

  • Understanding the Connected MOM Act: Federal Intervention in State Maternal Health Medicaid Coverage

    Understanding the Connected MOM Act: Federal Intervention in State Maternal Health Medicaid Coverage

    Introduction to Medicaid and Maternal Health Coverage

    Medicaid is a healthcare program designed to cover specific medical costs for individuals with lower incomes and limited resources. While the federal government sets baseline regulations and retains oversight authority over Medicaid programs, states maintain primary responsibility for program administration, which leads to variation in Medicaid coverage across the nation. Many state Medicaid programs offer insurance coverage for pregnant individuals through mechanisms such as presumptive eligibility. Presumptive eligibility allows certain vulnerable populations to receive coverage before their application for Medicaid is fully processed. For example, Iowa’s presumptive Medicaid coverage extends Medicaid benefits to all pregnant applicants while their eligibility is being determined, regardless of the final outcome.

    Maternal health remains a critical concern in the United States, where indicators such as preterm births and maternal mortality have continued to rise despite targeted policy interventions. A key factor in improving maternal health outcomes is access to high-quality prenatal care, yet adequate access to prenatal care is declining. A significant reason that many people cannot access adequate prenatal care is a lack of insurance coverage or sporadic insurance coverage during their pregnancy. Research emphasizes that increasing insurance coverage for pregnant people can improve access to prenatal care, which can improve maternal health outcomes.


    While federal regulations mandate certain Medicaid services, including maternal healthcare, the specifics of maternal health coverage are left largely to the discretion of individual states. For instance, Iowa’s presumptive eligibility for pregnant people continues until the applicant receives a determination of full Medicaid eligibility. In contrast, Minnesota’s hospital-based presumptive coverage for pregnant people only lasts for a month. 

    S.141 and the Scope of Federal Intervention

    Introduced on January 16, 2025, S.141—or the Connected MOM Act—aims to identify and address barriers to Medicaid coverage of health monitoring devices in an effort to improve maternal health outcomes. Given that health monitoring devices can expand access to prenatal care by allowing physicians to remotely monitor health metrics, the bill aims to explore how pregnant people might face challenges in obtaining these devices. The bill proposes investigating state-level obstacles to coverage of remote physiologic devices, which include: 

    • Blood pressure cuffs (used to monitor blood pressure)
    • Glucometers (used to assess blood glucose levels)
    • Pulse oximeters (used to measure blood oxygen saturation)
    • Thermometers (used to track body temperature)

    These devices enable at-home monitoring of key health metrics, facilitating earlier intervention for dangerous pregnancy-related conditions. According to legal experts, such investigative efforts generate data that can inform and support future policy development. S.B. 141, which has received bipartisan support, is currently under review by the Senate Finance Committee.

    Perspectives on S.B. 141 and Federal Medicaid Interventions

    Investigative legislation like the Connected MOM Act allocates funding for evidence-gathering to guide future policy decisions. In this case, the bill aims to collect information on how states manage Medicaid coverage for remote physiologic devices that are critical during pregnancy, with the long-term goal of shaping federal Medicaid policies. While supporters of the Connected MOM Act argue that it will provide necessary insights to catalyze Medicaid expansion for pregnant people, others point to the rules and regulations of Medicaid which make it difficult for the federal government to intervene broadly in state Medicaid programs. Given the structural limits on federal influence over state-run Medicaid programs, broad national reforms are often considered too costly or unlikely to yield systemic change. This dynamic was evident in the fate of H.R. 3055—the Black Maternal Health Momnibus Act—which failed to advance beyond the committee stage. Supporters of the Connected MOM Act argue that its incremental, investigative approach will help justify future reforms without being perceived as broad federal overreach. 

    Conclusion

    Each state administers its own Medicaid program, resulting in variations in coverage for certain medical devices, including remote health monitoring devices. Given the importance of these devices in expanding access to prenatal care, S.B. 141 seeks to investigate the best course of action for improving coverage of them across the nation. As it moves through committee, S.B. 141 may give insights on how policymakers can strategically navigate limits on federal power over state health programs.

  • The “Let Pregnancy Centers Serve Act” of 2024: Key Insights and Implications

    The “Let Pregnancy Centers Serve Act” of 2024: Key Insights and Implications

    What are Crisis Pregnancy Centers?

    Crisis pregnancy centers (CPCs) are nonprofit, community-based organizations that aim to ensure pregnant people carry their pregnancy to term. CPCs provide services, including pregnancy tests, ultrasounds, baby formula, and diapers to achieve their mission. While they have operated in the U.S. for decades, CPCs have become more prominent in the public eye in light of the Supreme Court’s Dobbs v. Jackson decision that overturned the national right to abortion. Contention has emerged concerning whether CPCs should continue to receive federal funding and qualify as eligible healthcare centers for patients using federal healthcare assistance programs. 

    Introduction to the Let Pregnancy Centers Serve Act of 2024

    The Let Pregnancy Centers Serve Act of 2024 was introduced to the Senate Committee on Finance by Senator Cindy Hyde-Smith [R-MS] on January 18, 2024, and is currently in the introduction stage. The Act contains two central provisions:

    1. Maintaining TANF Eligibility: Temporary Assistance for Needy Families, or TANF, is a government program that provides financial assistance to pregnant people and families for the purpose of accessing food, housing, healthcare, and other necessities. States have autonomy in implementing TANF, including determining the type and amount of assistance payments, and the services that can be obtained with TANF funds. The Act would ensure that people who receive TANF can use their benefits to pay for CPC services, and that CPCs can continue to receive TANF-delegated funding from the federal government.
    2. Renewing federal funding: The Act would prevent the federal government from denying CPCs funding via grants, on the basis that doing so merits federal discrimination against grantees. 

    Arguments in Support of the Let Pregnancy Centers Serve Act of 2024

    Enhanced Access to Pregnancy Services

    Proponents of the Act argue that PCPs should be praised for the broad range of goods and services they provide at little to no cost, such as baby clothes and formula. Early pregnancy confirmation is cheaper and more accessible at a CPC than at an abortion clinic, which supporters argue increases accessibility. They cite a study that showed that patients without health insurance were significantly more likely to visit a CPC than not to visit a CPC during their pregnancy. Additionally, proponents believe that the educational programs provided by some centers, such as parenting classes and prenatal care, help equip new and expecting parents with necessary knowledge and skills. In addition, some CPCs offer different types of emotional and psychological support. Advocates of the Act believe that the counseling services provided by some centers can help individuals and families navigate the pregnancy experience and its complexities. 

    Protection from Federal Discrimination

    One of the primary objectives of the Act is to ensure that CPCs continue to receive TANF funding. The bill aims to prevent the Biden administration’s proposed rule that would reduce or cut TANF funding to CPCs. Proponents argue that these centers play a crucial role in providing support to pregnant women, and that losing TANF funding eligibility could significantly impact their ability to offer essential services. Advocates of the bill argue that protection against federal discrimination is crucial for maintaining the viability of CPCs and ensuring they can continue to provide their service without undue interference. Advocates emphasize that CPCs have been allowed to receive federal funding since 1996, and that reversing this practice signals federal discrimination on a national scale. Proponents also argue that states should have the flexibility and power to direct funds to organizations that align with their values and priorities, and that the federal government would infringe upon state’s rights by prohibiting funding to CPCs nationally. 

    Arguments Against the Let Pregnancy Centers Serve Act of 2024

    Misleading Patients 

    Opponents of the Act argue that CPCs provide misleading or incomplete information about reproduction with the goal of preventing patients from seeking abortion, which can impact patients’ ability to make informed decisions about their health. Most crisis pregnancy centers have a religious affiliation and are not medically licensed, and thus fall outside the scope of consumer protection regulations that are designed to protect patients. Opponents argue that CPCs purposefully and unethically market themselves as health clinics, which has led to the development of websites like ExposeFakeClinics.com and The Anti-Abortion Pregnancy Center Database to warn patients about CPCs in their area. 

    Critics also claim that many ethical concerns that arise when the government provides TANF funding to organizations that are unqualified to provide medical advice. In particular, critics argue that CPCs’ main goal is to discourage or delay women from seeking abortion services, and that providing them with TANF funding could lead patients to perceive them as legitimate and objective healthcare providers. Delays in medical care, whether it be prenatal checkups or appointments about different options, can lead to more complex and costly procedures later on, and potentially put pregnant people’s lives at risk. Critics believe that by prioritizing funding for un-licensed pregnancy centers, the government risks misleading pregnant people into seeking services at centers with no medical credentials and thus neglecting their healthcare needs.

    Misuse of Federal Funds

    Additionally, opponents of the Act are concerned that CPCs lack the oversight and accountability required of other TANF-eligible medical facilities, which could increase the risk of mismanaged or ineffectively-used federal funds. While states must spend TANF funding on programs that achieve one of four TANF purposes, some argue that CPCs are deceptive and lack patient-centered care. Critics of the Act believe that TANF dollars could be used in more efficient ways than funding CPCs, such as promoting job preparation and work. They believe that funding CPCs risks diminishing government funds that could be used to fund prenatal care, contraceptive counseling, and more comprehensive maternal health services. Many believe that allowing TANF funds to support CPCs could weaken the overall monetary support network for reproductive health in the nation. 

    Conclusion

    The Let Pregnancy Centers Serve Act of 2024 aims to protect crisis pregnancy centers by allowing states to allocate TANF and other federal grant funds to these centers without federal interference. Supporters argue that CPCs offer vital services that deserve protection and uphold states’ rights to manage their grant distributions. Conversely, opponents express ethical concerns about funding centers that lack medical qualifications, licensure, and oversight. Critics warn that the Act could misallocate federal funds, diverting resources from licensed maternal and contraceptive care programs to less regulated centers. The legislation’s outcome will significantly impact pregnant individuals nationwide.