Wisconsin Republicans and Democrats agree on postpartum Medicaid coverage—but the Speaker doesn’t

The Wisconsin Senate passed a bill this week with overwhelming support from both sides of the aisle to expand Medicaid coverage for new moms for a full year after birth. Republican Assembly Speaker Robin Vos is now the obstacle in getting low-income mothers some help.

“Healthy moms raise strong babies, and maintaining access to care significantly reduces health care costs down the road.”

That’s what Wisconsin Senate President Mary Felzokowski (R-Tomahawk) said after a vote Tuesday on postpartum Medicaid expansion.

For a second time since last session, the state Senate passed a bill that would allow low-income mothers who make more than the poverty level to stay on BadgerCare Plus, Wisconsin’s largest Medicaid program, for a full year after giving birth instead of only two months.

Rare showing of broad bipartisanship

The measure received almost unanimous support, passing 32-1 with Sen. Chris Kapenga (R-Delafield) casting the only ‘no’ vote.

Rep. Robyn Vining (D-Wauwatosa) said, “I applaud the State Senate for coming together to pass the postpartum Medicaid extension, shifting coverage from 60 days to the critical and life-saving full year of health care coverage.”

“This is what governing looks like. Let’s do more of it.”

The American Lung Association, one of Wisconsin’s leading patient advocacy organizations, is one of many groups urging lawmakers to advance the legislation. “It says something important that 21 senators and 66 members of the Assembly in total have cosponsored this legislation,” said Advocacy Director Molly Collins. “We don’t see that type of support for many proposals, which just speaks to its relevance and importance to Wisconsinites.”

Sen. Jesse James (R-Thorp) is the bill’s author. He said Wisconsin has a responsibility to support mothers and babies.

“Bringing a child into the world is life-changing—physically, emotionally, and mentally,” James said. “And for many women, it’s not just sleepless nights and diaper changes.”

“It’s also battling postpartum depression, anxiety, high blood pressure, heart complications, and more at a time when the focus should be on healing and caring for a newborn.”

Only Wisconsin and Arkansas don’t provide coverage

Currently, people in Wisconsin are only eligible for Medicaid coverage if they make up to 100% of the federal poverty level, but pregnant women can receive Medicaid coverage if they have an annual income of up to 306% of the federal poverty level (that’s up to about $81,000 a year for a family of three). While a newborn whose mother is a Medicaid recipient receives a year of coverage, mothers risk losing their coverage after 60 days if they don’t otherwise qualify for Medicaid.

The extension of Medicaid coverage from 60 days to 12 months was made possible by President Joe Biden’s American Rescue Plan Act in 2021—and its initial five years of availability was later made permanent in 2023, providing the federal funds that cover the majority of Medicaid coverage. Because state budgets make up the difference, state governments had to choose whether to accept the funding and provide a longer window of stable, affordable health care coverage to women.

To date, 48 states have agreed to provide that coverage. Wisconsin and Arkansas are the only two states in the country to refuse expanding postpartum Medicaid coverage beyond the first two months. That’s despite many pregnancy-related health complications happening during that first year postpartum. Extending Medicaid coverage will give mothers vital care during this time, helping to reduce preventable deaths and improve long-term health outcomes for both mothers and babies.

“This bill is about keeping moms healthy, giving babies a stronger start, and making life better for the people we serve,” James said. “We know that 84% of pregnancy-related deaths are preventable, and many of these tragedies occur in the months after a mother’s coverage expires.

Collins said the death of a new mother represents not only the loss of a woman’s life, but it has a lasting impact on her new baby, her family, and her community. “This reinforces that action is needed to improve health outcomes for mothers, which in turn improves outcomes for babies.”

Why the bill will hit a roadblock

Democratic Gov. Tony Evers has been proposing covering mothers for a year in each of his budget proposals since 2019, but the Republican-led Legislature has rejected it each time. A Republican bill passed the Senate last session with only one opposing vote and also gained the support of a majority of Assembly lawmakers, but it never came to a vote.

Assembly Speaker Robin Vos (R-Rochester) has opposed the policy, saying that he doesn’t support expanding “welfare,” and has so far blocked its passage.

This week Vos said his position has been clear from the beginning and said he “can’t imagine” that he would ever support an expansion, “but we have to talk about it as a caucus.”

The Senate President said the expansion actually saves the state money in the long run by providing new mothers care that prevents issues from spiraling into something more serious. 

“If we can do small things like this with a high return on investment to start to slow that down, it makes sense for this state,” Felzokowski said. “It makes sense for our taxpayers, and that’s not even considering the moral and ethical reason we’re doing this.”

State Sen. Kelda Roys (D-Madison) notes that If the bill’s Republican supporters want to force a showdown with Vos, one way around his block would be to add the provision to the state budget bill.