Gov. JB Pritzker signs Illinois birth equality bill, celebrates Medicaid expansion

CHICAGO— Gov. JB Pritzker signed legislation Monday that expands coverage during and after pregnancy, a move aimed at lowering infant and maternal mortality rates, especially among black Illinoisans.

The law requires insurers that provide state-regulated health plans to cover pregnancy and postpartum services for covered individuals, including midwives, doulas and lactation consultants, for up to 12 months after the end of a pregnancy. Licensed or certified midwives will be required to be covered by 2025, while all other specified services must be covered by January 2026.

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

“The broad issue of maternal health has not been adequately addressed even in some of the best hospitals, especially for women of color,” Pritzker said. “We need to change the way this system works.”

Collins said this is not a local problem, but a widespread one.

“We understand that lives are at stake,” she said, “from Chicago to rural southern Illinois, women from every community, every ZIP code: they face unexpected complications during pregnancy and, without insurance, they face life-threatening, preventable complications.”

Lieutenant Governor Juliana Stratton said the birth equity initiative is an expansion of reproductive care.

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“This reinforces our administration’s belief that no one government should decide when or if a family grows, and ensures that when families do grow, both mother and child have access to the care they need,” Stratton said.

Stratton noted that the bill was signed the same day that Iowa’s ban on abortion after six weeks of pregnancy went into effect.

“I have to admit what a dark irony it is that we are celebrating Illinois’ work to empower women while our neighbors to the west woke up this morning with even fewer rights than they had last night,” Stratton said.

Gabel, who introduced the bill in February, said the United States as a whole needs to take action to make pregnancy safer.

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

Illinois’ preterm birth rate, a leading cause of infant death, has risen over the past decade, according to the March of Dimes, a nonprofit organization dedicated to improving the health of children and mothers in the U.S.

In the latest March of Dimes report for Illinois, the state gave a grade of “D+” for preterm births with a preterm birth rate of 10.6 percent, which, according to preliminary data, equates to about 13,000 preterm births in 2022. The nation also received a grade of “D+.”

Jeanine Valrie Logan, a midwife and leader of Chicago Beyond, the charity hosting the signing ceremony, expressed her vision of a society in which Black women receive ongoing care and safety long after pregnancy and childbirth.

“I imagine that not only will they be safe during pregnancy and after birth, but they will be safe throughout their lives,” Logan said. “It makes me sad to think of Sonya Massey and all the other families who are now mourning a senseless killing and the trauma of childbirth that could have been prevented.”

Medicaid will cover more services

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

“We are using them to direct Medicaid resources to initiatives that address the root causes of health care inequities, such as housing, food insecurity, unemployment, violence prevention, incarceration reentry, addiction treatment and more,” Pritzker said.

The waiver went into effect earlier this month. The federal approval means there are more matching funds from Washington that will now be available to Illinois programs.

The five-year waiver is part of a federal rule that allows states to extend Medicaid programs and test new programs and delivery models.

One area of ​​focus under the waiver is pre-release services for incarcerated people. State leaders said Medicaid-eligible people will be able to get help from case managers, including medication-assisted treatment, prescription drugs and medical supplies.

State lawmakers also welcomed the expansion, pointing to ongoing work to ensure equity in housing, health care and other areas.

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

Department of Health and Family Services Director Elizabeth Whitehorn said she hopes to see improvements in overall health outcomes for 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 print and broadcast stations throughout the state. It is funded primarily by the Illinois Press Foundation and the Robert R. McCormick Foundation, with major contributions from the Illinois Broadcasters Foundation and the Southern Illinois Editorial Association.