Underwood, Booker, Adams, Kelly, and Beatty Urge President Biden, Speaker Pelosi, and Leader Schumer to Include Critical Investments to Advance Maternal Health Equity in Final Build Back Better Package

WASHINGTON – In a letter to President Joe Biden, House Speaker Nancy Pelosi, and Senate Majority Leader Chuck Schumer, Representatives Lauren Underwood (IL-14), Alma Adams (NC-12), Robin Kelly (IL-02), Senator Cory Booker (D-NJ), and Congressional Black Caucus Chair Joyce Beatty (OH-03) pushed to ensure that investments from the Black Maternal Health Momnibus Act are included in full in the final Build Back Better package. Members also urged the leaders to build on the critical progress made through the American Rescue Plan Act by investing in the permanent expansion of yearlong postpartum Medicaid coverage in every state.

"Permanently expanding postpartum Medicaid coverage and advancing comprehensive investments in the Momnibus will uphold a principle that is fundamental to the Build Back Better Plan: that in America, every family has a right to thrive—a principle that begins with a safe and healthy pregnancy and birth. We must include these critical maternal health equity investments in the final Build Back Better reconciliation package," the Members wrote.

If passed, the Momnibus and postpartum Medicaid provisions in the Build Back Better package would be historic investments to save moms' lives, end racial and ethnic maternal health disparities, and advance birth equity across the United States. The letter echoes previous outreach to Leadership by more than 160 Members of the House and Senate advocating for the inclusion of the Momnibus and yearlong postpartum Medicaid coverage in a reconciliation package.

The United States has the highest rate of pregnancy-related mortality among high-income countries, and the only rate that is rising. Maternal mortality rates for Black and Native Americans are 2-4 times higher than rates for white Americans, and Hispanic and AAPI people also experience disproportionately high rates of maternal mortality and morbidity. The Black Maternal Health Momnibus Act includes 12 bills to build on postpartum Medicaid coverage expansion and comprehensively address the drivers of the maternal health crisis. The Momnibus makes critical investments in addressing social determinants of health, funding community-based organizations, growing and diversifying the perinatal workforce, and improving data collection processes.

Full text of the letter can be found here and below.

October 21, 2021

The Honorable Joseph R. Biden, Jr.
President
The White House
1600 Pennsylvania Avenue NW
Washington, DC 20500

The Honorable Nancy Pelosi The Honorable Charles E. Schumer
Speaker Majority Leader

United States House of Representatives United States Senate

Washington, DC 20515 Washington, DC 20510

Dear President Biden, Speaker Pelosi, and Majority Leader Schumer:

As negotiations continue on the Build Back Better reconciliation package, we urge you to ensure that critical investments to advance maternal health equity are included in full in the final package. Specifically, we write to express our strong support for all the maternal mortality investments in Sections 31041-31056 and postpartum Medicaid coverage investments in Section 30723 of the Build Back Better Act legislation that has advanced in the House Committee on Energy and Commerce. In total, these provisions cost approximately $3 billion – a fraction of a percent of the overall package – yet the impact would be significant, and the need could not be more urgent.

As you know, the United States has the highest maternal mortality rate of any high-income country and the only rate that is rising. The pregnancy-related mortality rate for Black and Native Americans is two to four times higher than the rate for white Americans, and Hispanic and AAPI people also experience elevated rates of maternal mortality and morbidity. These trends could worsen due to the COVID-19 pandemic, which has put pregnant people at greater risk for adverse birth outcomes.

Recognizing the pressing need to address these alarming trends, the Energy and Commerce Committee's Build Back Better Act legislation included historic investments to save moms' lives, end racial and ethnic maternal health disparities, and advance birth equity across the United States. The legislation would:

• Provide $175 million in funding for local entities to address social determinants of maternal health like housing, nutrition, and environmental conditions – including a minimum of $75 million exclusively for community-based organizations working to promote maternal health equity.

• Provide $275 million to grow and diversify the perinatal health workforce, including nurses, midwives, physicians, doulas, and maternal mental and behavioral health professionals – including $50 million specifically for doulas.

• Provide $100 million for maternal mental health equity grant programs.

• Provide $85 million to address the impacts of climate change-related maternal and infant health risks through health professional schools.

• Provide $50 million to advance maternal health research at Minority-Serving Institutions like Historically Black Colleges and Universities, Tribal Colleges and Universities, Hispanic-Serving Institutions, and AAPISIs.

• Provide $50 million to promote representative community engagement in Maternal Mortality Review Committees.

• Provide $160 million to strengthen federal maternal health programs like the CDC's Surveillance for Emerging Threats to Mothers and Babies program, Enhancing Reviews and Surveillance to Eliminate Maternal Mortality (ERASE MM), Pregnancy Risk Assessment Monitoring System (PRAMS), and the National Institute of Child Health and Human Development (NICHD).

• Provide $60 million to expand access to digital tools and technologies that promote maternal health equity.

• Provide $25 million for bias trainings among health care professionals.

These evidence-based investments from the Black Maternal Health Momnibus Act (Momnibus) center the families most severely impacted by our nation's maternal health crisis, and the provisions were shaped by women of color and local organizations that are on the ground in communities across the country, doing urgently important work to support pregnant people and new parents. To fulfill President Biden's priority of advancing racial equity in the Build Back Better reconciliation package, we must include these investments in full in the final package.

The Build Back Better Plan also includes a mandatory provision from the Mothers and Offspring Mortality & Morbidity Awareness (MOMMA's) and Maximizing Outcomes for Moms through Medicaid Improvement and Enhancement of Services (MOMMIES) Act that will make federal funds permanently available for states to spend on expanded postpartum Medicaid and CHIP coverage to one year in every state, with full state plan benefits throughout pregnancy and the yearlong postpartum period.

This critical investment builds on important progress we made through the American Rescue Plan Act of 2021, which included a provision to create a pathway for states to extend postpartum Medicaid coverage from the current standard of 60 days to one full year after the end of a pregnancy. While this state plan option was a significant step, expanding postpartum coverage remains optional for states, and the American Rescue Plan provision expires in five years. The Build Back Better reconciliation package is a once-in-a-generation opportunity to make yearlong postpartum Medicaid coverage a permanent reality for every mom in every state: we must get it done.

Permanently expanding postpartum Medicaid coverage and advancing comprehensive investments in the Momnibus will uphold a principle that is fundamental to the Build Back Better Plan: that in America, every family has a right to thrive—a principle that begins with a safe and healthy pregnancy and birth. We must include these critical maternal health equity investments in the final Build Back Better reconciliation package and we look forward to working with you to deliver on behalf of the mothers, babies, and families who are counting on us.

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