Washington Senate Finance Committee Chairman Chuck Grassley (R-Iowa) and Ranking Member Ron Wyden (D-Ore.) are today calling on stakeholders to submit data and findings on factors contributing to poor maternal health outcomes in the United States. The Senate Finance Committee leaders are also requesting specific, evidence-based solutions to address those factors and improve maternal health.
 
Rates of maternal mortality and morbidity are reaching crisis levels. There is widespread consensus among policy experts and stakeholders that pregnancy and childbirth too often include adverse events for women and infants, including death and other negative outcomes. According to a 2019 report by the World Health Organization and others, the maternal mortality rate in the US is 19 per 100,000 live births, compared to 7 per 100,000 in the UK and 6 per 100,000 in Australia. Similar disparities also exist when it comes to rates of negative health outcomes caused or aggravated by pregnancy and childbirth. Within the United States, the maternal health crisis particularly affects women of color who, on average, experience worse outcomes, as well as women living in rural areas.   
 
“We have the opportunity and resources to make real improvements in maternal health. There’s no reason why our country should lag behind others when it comes to health during pregnancy and during the postpartum period. These deaths are tragic and avoidable, and I look forward to reviewing the recommendations and working on a legislative path forward,” Grassley said.
 
“In a country that spends as much on health care as the United States, American mothers should not have to fear for the well-being of their child or themselves during or after a pregnancy,” Wyden said. “This effort aims to find legislative solutions this year that help improve access to care, address disparities in maternal health including those that disproportionately affect women of color, and ensure pregnant and postpartum individuals receive the comprehensive, high-quality, and safe care they deserve. Expecting mothers and their loved ones cannot wait for the health care system to improve their care - it’s time for Congress to act.”
 
To date, Congress has considered a number of initiatives aimed at addressing maternal health. Proposals within the jurisdiction of the Senate Finance Committee include extending Medicaid and CHIP coverage for individuals during the postpartum period; ensuring the full range of comprehensive benefits for pregnant and postpartum women; advancing evidence-based maternity care models; improving access to and collaboration among health care providers including non-physician providers; advancing quality measures, collaboration, coordination and reporting for maternal and infant health; among others.
 
The committee asks for specific feedback on the policies included in these proposed initiatives. Additionally, the committee welcomes input on other evidence-based policies to improve maternal health including, but not limited to, those that fall into the following areas:
 
  1. Use of non-physician clinicians and continuity, coordination of care. Proposals may include incorporating more certified nurse midwives and other non-physician health professionals into the maternal health landscape, as well as proposals to improve continuity of care, and coordination of care that include local community partners.
  2. Coverage and standards of care to improve maternal health. Such proposals may seek to improve access to, comprehensiveness, and affordability of coverage as well as policies to reform payment models within the Medicaid program to improve maternal health.
  3. Addressing disparities and disparate outcomes. Such proposals may include those advancing policies to help address disparities in maternal mortality and morbidity that affect women of color and other populations experiencing high rates of adverse outcomes including those living in rural areas. 
  4. Data collection and effective evaluation to improve outcomes and quality. Submissions may review existing definitions, standards, and evaluation methods, as well as include other proposals for states and other relevant stakeholders to collect, analyze, and report on data to improve outcomes and quality of care for pregnant and post-partum women.
  5. Social services aimed at supporting mother and child wellbeing. Recommendations may include social services with an evidence base suggesting that services may mitigate health risks associated with the perinatal period, improved health and social service coordination, or other efforts to address non-medical needs that affect the wellbeing of mothers and children at risk for adverse outcomes.
 
In order to be considered, proposals must be submitted on a timely basis, be within the committee’s jurisdiction, and specific to Medicaid, CHIP (Children’s Health Insurance Program), Medicare and human services. Any submitted recommendation should be evidence-based and include relevant data or research. Proposals should be reasonably expected to have a direct impact on maternal health including maternal mortality or morbidity.
 
Please send submissions to MaternalHealth@finance.senate.gov no later than March 20, 2020. The committee will use this process to develop and advance meaningful policies to address maternal health that can be included in the most appropriate and timely legislative vehicle. Senate Finance Committee members and staff look forward to robust stakeholder input on this critical issue.
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