Pritzker signs birth equity initiative into law, celebrates Medicaid expansion

Gov. JB Pritzker signed a law Monday that expands insurance coverage during and after pregnancy with the goal of lowering infant and maternal mortality rates, especially for Black Illinoisans.

The law requires insurers that provide state-regulated health care plans to cover pregnancy and postpartum services for covered individuals, including midwife services, doula visits and lactation consultants for up to 12 months after the end of a pregnancy. Licensed or certified midwives will need to be covered by insurance providers starting 2025, while all other outlined services must be covered by January 2026.

Pritzker, who was joined by advocates and sponsors of the bill, state Rep. Robyn Gabel, D-Evanston, and state Sen. Lakesia Collins, D-Chicago, said the state still has more work to do.

“The broad issue of maternal health, it’s not been done adequately even in some of the best hospitals, when we talk about women of color, in particular,” Pritzker said. “We’ve got to change the way this system operates.”

Collins said this is not a localized problem but a pervasive one.

“We understand that lives are on the line,” she said, “from Chicago to rural southern Illinois, women across every community, every ZIP code: they face unexpected complications during pregnancy and without the coverage of insurance, are faced with life-threatening complications that are preventable.”

Lt. Gov. Juliana Stratton said the birth equity initiative is an extension of reproductive care.

“It bolsters our administration’s belief that no government should decide when or if a family grows and ensures that when families do expand, both mom and baby have access to the care they need,” Stratton said.

Stratton noted the bill signing happened the same day Iowa’s six-week abortion ban took effect.

“I have to acknowledge how darkly ironic it is that we celebrate Illinois’ work to empower women, as our neighbors to the west woke up this morning with even fewer rights than they had last night,” Stratton said.

Gabel, who introduced the legislation in February, said the U.S. as a whole needs to try to make pregnancy safer.

“It is shocking that the wealthiest nation that has ever existed in this world has this problem,” she said of the country’s drastically high maternal mortality rate. “It must and will be addressed.”

The preterm birth rate in Illinois, one of the leading causes of infant death, has increased over the past decade, according to March of Dimes, a nonprofit aimed at improving the health of babies and mothers in the U.S.

The latest March of Dimes report card for Illinois gave the state a ‘D+’ preterm birth grade for a preterm birth rate of 10.6% , which, based on preliminary numbers, equates to about 13,000 preterm births in 2022. The country also received a ‘D+’ grade.

Jeanine Valrie Logan, a midwife and leader at Chicago Beyond, the philanthropic organization hosting the signing ceremony, expressed her vision of a society where Black women are continually cared for and kept safe, well beyond pregnancy and childbirth.

“I also envision them not only being safe in their pregnancy and postpartum but also their whole lives,” Logan said. “It saddens me to think about Sonya Massey and all the other families that are grieving now for senseless killing and preventable childbirth trauma.”

Medicaid to cover more services

Pritzker and many of the same lawmakers at the birth equity signing later celebrated a federal waiver that expands the number and scope of services the state can cover under Medicaid. The 1115 waiver allows such things as housing, food and nutrition services, and violence intervention services to be reimbursed by the health care program that serves low-income individuals and is jointly funded by the state and federal governments.

“We are using it to direct Medicaid resources toward initiatives that address the root causes of health inequalities such as housing, food insecurity, unemployment, violence prevention, reentry from prison settings, substance use treatment, and more,” Pritzker said.

The waiver took effect earlier this month. Federal approval means there are more matching funds from Washington that will now be available for programs in Illinois.

The five-year waiver is part of federal rules that allow states to stretch their Medicaid programs, and test new programs and delivery models.

One of the focus areas in the waiver is prerelease services for incarcerated people. State leaders said those who are Medicaid-eligible will be able to get help from case managers, including medication-assisted treatment, prescription medicines and medical supplies.

State lawmakers cheered the expansion as well, pointing to ongoing work to bring equity to housing, health care and more.

“I fully understand that we cannot advocate for people to live strong, healthy lives without addressing social determinants of health and the inequitable outcomes they result in,” said state Sen. Omar Aquino, D-Chicago. “With a focus on quality, innovation and equity, I’m excited this waiver will allow our state to tackle interconnected issues like housing, health and food security, fostering a more holistic care system where everyone can get the treatment they need.”

Department of Healthcare and Family Services Director Elizabeth Whitehorn said she hopes to improve overall health in vulnerable populations. The agency expects it will take several months before all eligible programs are fully included in the expansion and available to residents.

Capitol News Illinois is a nonprofit, nonpartisan news service covering state government. It is distributed to hundreds of newspapers, radio and TV stations statewide. It is funded primarily by the Illinois Press Foundation and the Robert R. McCormick Foundation, along with major contributions from the Illinois Broadcasters Foundation and Southern Illinois Editorial Association.