Wisconsin’s recent passage of legislation extending Medicaid postpartum coverage to 12 months, signed into law on February 24, 2026, leaves Arkansas as the sole remaining state without such an extension, according to Georgetown University’s Center for Children and Families.
The move comes after the American Rescue Plan Act of 2021 initially offered states a pathway to extend coverage from the standard 60 days postpartum to a full year through a state plan amendment (SPA). While the initial provision was set to expire after five years, the Consolidated Appropriations Act of 2023 made the option permanent, incentivizing states to adopt the extended coverage period.
Currently, Medicaid finances approximately 4 in 10 births nationwide. Federal law mandates coverage for pregnancy-related services through 60 days after childbirth. However, this limited timeframe often leaves new mothers vulnerable, as a significant proportion of maternal deaths – roughly one-third – occur between one week and one year postpartum. Causes for these deaths include preventable conditions like overdose and suicide.
The American College of Obstetricians and Gynecologists (ACOG) has been a leading advocate for extending postpartum Medicaid coverage, citing the rising rate of maternal mortality and the critical need for continuous care during the postpartum period. ACOG has actively lobbied Congress and the administration to support state efforts and has urged the Centers for Medicare & Medicaid Services (CMS) to expedite the approval of state plan amendments and Section 1115 waiver requests.
Prior to the American Rescue Plan Act, some states extended postpartum coverage through alternative means, utilizing section 1115 waivers or state funds. The SPA option, which took effect on April 1, 2022, provided a streamlined process for states to implement the 12-month extension. CMS released guidance on implementing the SPA on December 7, 2021.
The extension of postpartum Medicaid coverage is particularly crucial in light of the ongoing Medicaid unwinding, which began in April 2023. This process involves states re-evaluating eligibility for Medicaid recipients, potentially leading to the loss of coverage for many individuals. Extending Medicaid during the postpartum period can help mitigate coverage gaps and ensure continuity of care for new mothers.
As of February 24, 2026, the majority of states have taken action to extend postpartum Medicaid coverage, either through the SPA process or other mechanisms. Arkansas remains the only state that has not yet implemented a 12-month extension, leaving a significant gap in maternal health coverage for its residents.
