Missouri considers unprecedented addiction help for moms

JEFFERSON CITY, Mo. -- The Missouri Senate is considering a bill that would extend Medicaid for new mothers struggling with addiction, a notable expansion for a state that did not expand Medicaid after the Affordable Care Act passed in 2010.

Missouri's Medicaid now covers substance-abuse programs for about two months after a woman gives birth. The bipartisan proposal, which passed the House last month in a 139-6 vote, would extend Medicaid a year beyond that, as long as the mother continued to receive treatment. A Senate hearing on the bill is scheduled for Tuesday.

"People don't ask to be addicted," said Rep. Marsha Haefner, a Republican of St. Louis and the bill's sponsor. "We need to treat them as though they have an illness."

Nationally, opioid use among pregnant women has risen sharply. In 2012, the number of newborns displaying signs of opioid withdrawal was five times higher than it was in 2000, according to the National Institute of Drug Abuse.

The state would need a waiver from the federal government to enact the change, and it appears Missouri's would be the first request of its kind.

Legislative researchers estimate more than 1,200 women could be eligible for the extension each year, which could cost the state more than $4 million.

Supporters argue the program's ripple effects could lead to savings elsewhere, such as the foster care system.

The Department of Social Services spends more than a quarter of a billion dollars every year on the thousands of foster children in Missouri, and congressional researchers have estimated almost a third of children in foster care throughout the country are there partly as a result of a parent's addiction.

"This is a really risky time for moms," said Cynthia Rogers, a psychiatrist at St. Louis Children's Hospital. At least half of people who struggle with addiction relapse, she said, and the challenges faced immediately after birth only increase a woman's stress.

"They were really motivated during pregnancy, and then you're sending them home now with an infant that is high needs," she said.

The added coverage also could have positive ripple effects. Melinda Monroe Ohlemiller, CEO of the home health-care organization Nurses for Newborns, said there is a strong correlation between a mother's health and a baby's.

No one spoke against the proposal when it was debated in a House committee. The six lawmakers who voted against the proposal in the House either declined to comment or did not respond to requests for comment.

The bill is HB 2280