12-month postpartum Medicaid in Pennsylvania

Pennsylvania Medical Assistance has extended postpartum Medicaid coverage from the federal minimum of 60 days to 12 months. The extension took effect 2023-04-01 and was authorized under Section 9812 of the American Rescue Plan Act (2021), which allowed states to make the extension permanent through a State Plan Amendment.

What the extension covers: the same Medicaid benefits you had during pregnancy — primary care, specialty care including cardiology and behavioral health, prescription drugs, dental, vision, and transportation to appointments. Crucially, it covers screening and treatment for the leading causes of late-postpartum death: cardiovascular and cardiomyopathy events (roughly a third of US pregnancy-related deaths), mental-health and substance-use conditions, and infections.

What you need to do to keep coverage: generally nothing during the 12 months — Pennsylvania Medical Assistance is required to provide continuous eligibility. At the end of the 12-month window, the state will check whether you still qualify under another Medicaid category (expansion adult, parent, disability-based). If you no longer qualify for Medicaid, you will be referred to the health insurance marketplace for ACA subsidies with a special enrollment period triggered by loss of Medicaid.

Governor Tom Wolf rolled back Corbett-era Healthy PA work requirements in his first year (2015), fully implementing expansion. Act 117 of 2023 directed the Department of Human Services to pursue a Section 1915(i) State Plan Amendment to add doula services — implementation was expected in 2025.