(Photo courtesy of Pexels-Anna Shvets)

LANSING — Michigan expanded Medicaid coverage for new mothers after they give birth from two months to 12 months in April 2022, a key component of Gov. Gretchen Whitmer’s Healthy Moms, Healthy Babies initiative.

The effort strove to reduce illness and death rates by giving new mothers continued access to affordable care.

Immigration rights advocates say the initiative leaves some women behind.

Undocumented immigrants are still provided only two months of postpartum coverage since they have limited access to Medicaid benefits.

The current two months’ coverage is provided under the state’s Maternity Outpatient Medical Services program, or MOMS, which serves between 4,000 and 5,000 people a year. The program also covers pharmaceuticals, prescription vitamins, radiology treatment, ultrasound, and labor and delivery fees for mothers.

Simon Marshall-Shah, a senior policy analyst at the Michigan League for Public Policy, said the organization wants the state to extend such coverage under the MOMS program to 12 months, matching standard Medicaid coverage.

“Undocumented women are the only group of people who are excluded from postpartum coverage under Medicaid,” Marshall-Shah said. “That’s a change that we’d like to see.”

Susan Reed, the director of the Michigan Immigrant Rights Center in Ypsilanti, said health care coverage is a “constant source of struggle” for undocumented people. Without the right immigration status, immigrants qualify for only limited coverage under a program called Emergency Services Only Medicaid.

“It covers almost nothing,” Reed said. “It just covers emergency lifesaving medical treatment. It doesn’t cover any kind of therapeutic or ongoing care.”

Pregnancy-related care is covered under the MOMS program, which Reed said is similarly limited.

“Greater access to postpartum care would be wonderful for children and families,” Reed said.

Babies of undocumented mothers are automatically U.S. citizens and get full coverage regardless of their parents’ citizenship status, she said.

A study in the Journal of the American Medical Association found that immigrants in states with health insurance restrictions are less likely to receive postpartum care. That can have dire consequences, said Laura Wherry, a professor and researcher at New York University.

“There are serious and potentially life-threatening conditions, such as hypertension and depression, that are common during that first year following delivery,” Wherry said.

Marshall-Shah said he expects the effort in Michigan, if successful, to cost an additional $6-$10 million a year.

Expanding health care to undocumented immigrants outweighs the financial burden, according to Wherry’s research.

California became the first state to expand Medicaid access to undocumented immigrants in 1988. Wherry used data from the U.S. Census Bureau to track the effect of that state’s landmark action.

She found that access to health care during the birth process resulted in significantly better health for babies in California. Those benefits continued through the rest of their lives, the data showed.

“They go to post-secondary school at higher rates and they graduate college at a higher rate,” Wherry said. “They’re less likely to use public benefits later in childhood and in adulthood.”

“If you take all of these long-run benefits into account, the government fully recovers the cost of providing this type of Medicaid coverage to undocumented immigrants,” Wherry said.

Reed said Medicaid coverage for undocumented people is often an unrecognized problem.

“There is a perception that there is a lot of aid available to undocumented people,” Reed said. “The reality is one of exclusion from virtually all public benefits and programs, or severe limits on what folks can receive.”