Wisconsin is one of only two states that does not offer a full year of Medicaid coverage to certain low-income mothers after they give birth, a distinction that a group of GOP state lawmakers again is seeking to change, despite opposition from a key Republican leader.

Most of the state’s lawmakers have again signed on to a bill authored by Republicans that would allow low-income mothers who make more than the poverty level to stay on BadgerCare Plus, the state’s largest Medicaid program, for a full year after giving birth, instead of only two months.

The only other state that does not offer a full year of coverage is Arkansas, according to the KFF, a health policy research group.

For months after giving birth, women are still at risk for a range of life-threatening, post-pregnancy complications, including heart conditions, clotting disorders, postpartum depression and more. Statewide, a third of the 63 pregnancy-related deaths in the three years from 2020 to 2022 occurred more than two months after giving birth, said Arielle Exner, legislative director at the state’s Department of Health Services.

In addition, women with high blood pressure or other conditions who lose health coverage midway through the postpartum period could see their conditions worsen to the point they become chronic or threaten their long-term health, supporters said during a Wednesday hearing on the bill before the state Senate Committee on Health.

In the last few years, most states without a year-long coverage period for postpartum women have approved it, making it part of their Medicaid programs. In red-leaning states, Republicans promoted the extension of coverage as a central part of their pro-life agenda, in the wake of the U.S. Supreme Court ruling to overturn the constitutional right to abortion.

“We as a state are unfortunately behind on this issue,” said state Sen. Jesse James, R-Thorp, an author of the Wisconsin bill, at Wednesday’s hearing. “We have a chance to do better for our moms, our kiddos and our families as a whole.”

In Wisconsin, similar bills have been introduced in the last two legislative sessions, only to stall in one or both chambers.

Last session, a state Senate bill to extend coverage passed by a 32-1 vote, but the bill never made it to a floor vote in the Assembly, even though a majority of the Assembly had signed onto the bill as co-sponsors.

At the time, Assembly Speaker Robin Vos, R-Rochester, opposed the bill, saying during a Q&A in 2023 “we give away too much free stuff” and that after pregnancy, women could sign up for a private health plan on the marketplaces set up through the Affordable Care Act.

“We want to encourage people to leave the public sector and enter the private marketplace as quickly as we can, not keep them on Medicaid even longer than they already are,” he said at the time.

Pregnant women whose household income is three times the poverty level or less qualify for BadgerCare Plus during pregnancy and for about two months after. Currently, only mothers who make as much as the poverty level or less qualify to stay on BadgerCare Plus beyond that second month.

Donna Rozar, a former state representative and an author of last session’s legislation to extend coverage, said new mothers shouldn’t have to worry about health coverage.

“If you have a two-month-old baby, the last thing you want to do is change insurance programs,” she said at Wednesday’s hearing on this session’s bill.

Supporters of the bill stressed that having to switch health insurance soon after birth could lead to a break in coverage when patients are between plans or to disruptions in care if patients have to switch doctors.

For women going through mental health challenges, such as postpartum depression, on top of it all, it can be even tougher.

“It is hard to access health care. It’s even harder to access mental health care,” said Kathleen Hipke, a licensed clinical psychologist who spoke at Wednesday’s hearing. “Trying to find new health care providers, navigate wait times – by the time these things happen, we’ve already exceeded the 60-day period.”

Gov. Tony Evers, a Democrat, has included an extension of postpartum Medicaid coverage in previous biennial budget proposals, only for Republican lawmakers writing the state budget to remove the year-long extension from consideration.

Asked at a news conference last month whether a bill to extend postpartum coverage would get a vote in the Assembly this year, Vos said he thought it “unlikely.”

“Our caucus has taken a position that expanding welfare is not a wise idea for anyone involved,” Vos said.

But many Republicans in the state Assembly and the Senate, in fact, are co-sponsors of the bill. Like in previous legislative sessions, the bill was authored by Republicans, among them Rep. Patrick Snyder, R-Weston, who was standing behind Vos when he made those comments last month.

At Wednesday’s hearing, Snyder said he hoped Wisconsin passed the legislation before Arkansas, the only other state without the extension.

“It’s the right thing to do,” Snyder said. “The bill is not partisan in my mind. … I’m into helping people, my constituents, and if we can’t get something like this done, then I don’t know what I’m doing in the Legislature.”

If the bill passes, it would mean about 5,000 more women per month would be covered by BadgerCare Plus, Exner, the DHS legislative director, said. The annual cost of implementing the extension would be about $18.5 million in state and federal funds. Of that total, about $7.3 million would come from the state, she said.

About one in three births in Wisconsin were covered by BadgerCare Plus or another Medicaid program in 2023, Exner said.

On Wednesday, longtime supporters of the legislation, including medical professionals with the Wisconsin chapter of the American College of Obstetricians and Gynecologists, reiterated that the bill would likely save lives.

Amy Domeyer-Klenske, an OB-GYN in Madison who spoke on behalf of ACOG, recounted a patient who suffered worsening high blood pressure and a life-threatening blood clot after delivery and who required blood thinners and frequent adjustments to her medication that were necessary beyond two months postpartum.

“When we see women who lose their coverage who are newly requiring these medications, we worry as physicians about what will happen to them, their risk for things like heart disease, stroke and death in the upcoming year and beyond,” she said. “We are failing to cover mothers like this across Wisconsin.”