Arkansas is the only U.S. state that does not guarantee 12-month postpartum insurance coverage through Medicaid for low-income mothers. The Arkansas Advocates for Children and Families (AACF) is calling on Arkansas officials to extend the coverage.
With the vote of 95-1, the Wisconsin Assembly on Thursday (Feb. 19) approved the extension of Medicaid coverage from 60 days to one year. That vote leaves Arkansas as the only state without an extension.
Wisconsin officials have estimated that a fully-implemented extension will cost the state about $9.4 million, with the federal government paying an additional $14.1 million, according to a ProPublica report. Wisconsin’s population is almost double that of Arkansas.
“With Wisconsin’s passage, Arkansas is now the only state in the nation without expanded postpartum Medicaid coverage,” the AACF noted in a Friday (Feb. 20) press release.
The AACF says the extension is critical following recent data showing that 44% of postpartum mothers in Arkansas lost Medicaid coverage in the fourth quarter of 2025. The AACF said the decline is the worst quarterly performance since tracking began. According to AACF, the state is in a maternal health care crisis, with Medicaid paying 41% of all births in Arkansas. The recent “coverage retention” collapse will make the situation worse, according to the Little Rock-based advocacy organization.
The AACF estimates that 131,000 Arkansans could soon lose all forms of healthcare coverage because of federal policy changes, which include expiration of tax credits.
“This data should alarm every Arkansan who cares about maternal health,” said AACF Executive Director Keesa Smith-Brantley. “Women are losing coverage right when they’re most vulnerable to life-threatening complications. We need action now.”
‘FUNDAMENTAL REQUIREMENT’
According to The American College of Obstetricians and Gynecologists (ACOG), more than 80% of pregnancy-related deaths occur after delivery—with many preventable through access to continuous care.
Arkansas has the nation’s fourth highest maternal mortality rate in 2018-22 among the 39 states where data was available in 2018-22, according to KFF, a health policy research group. The state’s rate was 38 deaths per 100,000 live births. The national average was 23. The state had the third highest infant mortality rate in 2022 with 7.67 deaths per 1,000 live births, according to the Centers for Disease Control and Prevention. There were 272 infant deaths in Arkansas that year.
“Every day of uncovered care during the postpartum period is a day that complications could go untreated, medications could go unfilled, necessary care could go unmet,” said AACF Health Policy Director Camille Richoux. “We’ve spoken to women across the state facing serious issues from postpartum depression to ongoing c-section complications who have lost access to health care following childbirth. Postpartum coverage is not a luxury, it’s a fundamental requirement for maternal and child health in Arkansas.”
‘HEALTHY MOMS, HEALTHY BABIES’
The Arkansas Legislature in 2025 passed the Healthy Moms, Healthy Babies Act to begin addressing the state’s poor performance with maternal and infant health outcomes. Measures in the Act included allowing a pregnant woman to be eligible for Medicaid so that prenatal care is provided immediately rather than waiting for the application to be processed.
The Act also unbundled Medicaid payments so that physicians can be paid during prenatal, delivery, and postpartum phases instead of the payment held as a lump sum at the end of the pregnancy. The Act also updated payment rates, adding $45 million in state and matching federal funds, the bulk of it for deliveries and office visits.
“Arkansas is at an inflection point in maternal health,” said Dr. Nirvana Manning, chair of Obstetrics and Gynecology at University of Arkansas for Medical Sciences, and director of the Arkansas Center for Women & Infants’ Health, said in an August 2025 press release. “We are seeing an unprecedented level of coordination, from legislation at the Capitol to clinical care in each county, and this roundtable is our call to action.”
