Why It Matters

State maternal mortality review committees are driving policy changes aimed at preventing pregnancy-related deaths, including expanded postpartum Medicaid coverage and efforts to address mental health, substance use, and racial disparities, according to a new report from the U.S. Government Accountability Office (GAO).

GAO found that representatives from five of 10 selected committees said their states extended Medicaid coverage for certain women to 12 months postpartum based on committee recommendations, while nine committees issued recommendations addressing mental health and substance use and nine made recommendations focused on health equity.

The Big Picture

Unintentional drug overdose and suicide rank among the leading causes of death among pregnant and postpartum women, according to a recent study cited in the report. Nine of the 10 selected MMRCs made recommendations in the area of mental health and substance use, including calls for expanded screening, referrals for treatment, and increased funding for access to care.

Racial and ethnic disparities run through the data: both Black and American Indian/Alaska Native women experience pregnancy-related deaths at a rate 2.5 or more times higher than White women, according to GAO's previous work and CDC. Nine of the 10 selected MMRCs recommended addressing these disparities, with one committee specifically recommending that American Indian/Alaska Native communities be represented in planning and implementing improvements in maternity care.

Beyond Medicaid and health equity, the 10 MMRCs commonly made recommendations across five areas: care coordination, mental health and substance use, health equity, reproductive health, and health care workers. All 10 committees reported considering federal and state laws and policies as potential factors affecting maternal mortality when conducting their reviews.

On the oversight side, GAO found that CDC has incorporated key performance management practices identified in prior GAO work, including setting a goal of eliminating preventable deaths and collecting data on how many MMRC recommendations are implemented. CDC monitors the committees through regular meetings, reviews of required reports, and site visits. The report is structured as a Q&A and does not include formal recommendations to a federal agency.

The approximately $134 million CDC plans to provide over the five-year funding cycle from 2024 through 2029 represents a federal investment in state- and territory-level infrastructure to understand and reduce maternal deaths. With 52 states and territories receiving funds, the program's reach is national, even as recommendations from individual MMRCs are tailored to local conditions, laws, and populations.

The Bottom Line

With the five-year CDC funding cycle running through 2029, MMRC recommendations cover areas including Medicaid postpartum coverage, mental health and substance use, and racial health disparities. Nine of the 10 selected MMRCs made recommendations in the area of mental health and substance use, where unintentional drug overdose and suicide were among the leading causes of death among pregnant and postpartum women.

Representatives from five of the 10 selected MMRCs said their states changed state laws to extend Medicaid coverage for certain women to 12 months postpartum based on MMRC recommendations. The report does not identify a specific congressional requester. Readers can track related federal legislation and oversight activity at Legis1.com.

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