Hollywood celebrities brought the issue of postpartum depression out of the shadows, but that does little to help the moms in poverty who are trying to cope with an infant and feelings of overwhelming sadness at the same time.
Their struggle is a far lonelier one, made more difficult by federal Medicaid rules that limit the medical treatment covered by that insurance to 60 days past the birth of the child — despite a strong body of evidence that for many women the symptoms may not appear for months and can last for a year or more.
There are efforts in Washington to change the rule, and Massachusetts is among several states that have applied for a federal waiver that would allow its MassHealth program to offer coverage for a full 12 months past a birth. But there’s been no action on either so far.
So once again the pressure mounts on state lawmakers to act to make sure the state’s neediest women can get care for the long haul — even as legislators ponder more sweeping efforts to achieve genuine parity for mental and behavioral health care coverage.
“We’re all on this committee working toward treatment of mental illness and substance abuse disorder just like we cover heart disease and diabetes,” said Senator Cindy Friedman, cochair, with Representative John Lawn, of the Committee on Health Care Financing, which heard testimony Tuesday on the postpartum depression bill and a number of other bills aimed at improving availability and coverage of mental health services.
Friedman and Senator Julian Cyr have been tasked by Senate President Karen Spilka with drafting an updated version of a long-stalled mental health parity bill. House inaction on the sweeping Senate-passed bill allowed it to die on the legislative vine in 2020.
Spilka is vowing to get it to the governor’s desk this year. And Governor Charlie Baker, in a Tuesday speech to the New England Council, pledged to go back at a health care reform bill that would address behavioral health and substance abuse services — probably next year.
Meanwhile, there are some incremental changes that can be made now and can make a difference. And, as Friedman put it at the hearing, “It’s just such common sense to take care of mothers and babies.”
The bill to extend MassHealth coverage for new mothers has wide-ranging support, including that of the Massachusetts Medical Society, whose president, Carole Allen, a pediatrician, called the bill “essential,” adding that inadequate maternal care is bound to lead to greater racial and ethnic disparities. MassHealth patients, she added, are also more likely than private-pay patients to have underlying health conditions even before pregnancy.
Given that MassHealth covers some 35 percent of all births in the state, the matter of providing adequate postpartum depression coverage to those new mothers could potentially impact thousands of women a year.
“Roughly one-third of pregnancy-related deaths occur in the postpartum period, which can last several months; pregnancy-related deaths from preventable causes, including overdose and suicide, also occur more frequently during this period,” according to written testimony from the MMS provided last spring in support of the state’s waiver request.
Representative Liz Miranda of Boston, who filed the PPD bill along with Senator Joan Lovely, said in a statement, “Six out of ten zip codes in the state with troubling Black maternal health outcomes are in my district. It’s time to bridge maternal health care and racial justice to save more Black lives.”
The health care community here is clearly on the same page. New mothers — especially those already facing financial challenges — shouldn’t be forced to forgo treatment that could save their lives just because Washington bureaucrats somehow came to believe two months is time enough for mom to “get back on her feet,” nurse her new baby, and carry on.
Maybe Washington will fix this — maybe not. What is clear is that not another year should go by here in Massachusetts in which new mothers and their families wait for sufficient help. That’s not who we are. We can do better.
Editorials represent the views of the Boston Globe Editorial Board. Follow us on Twitter at @GlobeOpinion.
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Caring for new moms shouldn’t depend on who pays the bill - The Boston Globe
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