THE SENATE	S.C.R. NO.	191
THIRTY-FIRST LEGISLATURE, 2021
STATE OF HAWAII

SENATE CONCURRENT

RESOLUTION

 

 

urging the united states department of health and human services to amend its policies relating to postpartum sterilization waiting periods for medicaid RECIPIENTS.

 

 

        WHEREAS, postpartum sterilization is a form of contraception for women in which a doctor cuts and closes or completely removes the fallopian tubes shortly after a woman gives birth; and

 

        WHEREAS, postpartum sterilization is the most commonly used form of contraception in the United States; and

 

        WHEREAS, postpartum sterilization is safe, effective, and provides substantial cost savings for healthcare systems by reducing unintended pregnancy without increasing the length of hospitalization; and

 

        WHEREAS, significant systemic barriers to postpartum sterilization exist for people insured under Medicaid, a federal program that covers select low-income populations; and

 

        WHEREAS, Medicaid is the nation's largest single payer of maternity benefits, covering nearly one-half of all births in the United States and a greater share of births among Hispanic, African American, Native American, and Native Alaskan populations compared with private insurance; and

 

        WHEREAS, federal regulations require strict consent parameters, including a thirty-day waiting period for Medicaid enrollees, to reimburse providers for the sterilization procedure, and failure to comply with these federal regulations can result in reimbursement denial for delivery and postpartum care; and

 

        WHEREAS, in contrast, privately insured individuals are not generally subject to a thirty-day waiting period between consent and surgery, creating a two-tiered system of access that restricts reproductive autonomy to those who can afford it; and

 

        WHEREAS, as a result, postpartum sterilization rates among Medicaid enrollees who desire it are lower than privately insured individuals, even after controlling for hospital and patient factors; and

 

        WHEREAS, a prospective study on publicly insured participants requesting immediate postpartum sterilization found that fifty-six percent of requests went unfulfilled, and in over two-thirds of those cases, problems with the Medicaid consent form were cited as the reason; and

 

        WHEREAS, the most common issues reported with the form were that the consent form was not completed, the minimum waiting period had not elapsed, and the consent form contained errors; and

 

        WHEREAS, almost one-half of individuals who had unfulfilled sterilization requests had a pregnancy within one year, and these pregnancies can incur substantial emotional, physical, and financial costs to families and birthing individuals, as well as a direct cost of billions of dollars annually to the healthcare system; and

 

        WHEREAS, regulations that place an additional undue burden on patients and families who already face systemic disadvantage and poor health outcomes, particularly low-income people and people of color, should be abolished or revised to ensure fair and equitable access to all reproductive health services; now, therefore,

 

        BE IT RESOLVED by the Senate of the Thirty-first Legislature of the State of Hawaii, Regular Session of 2021, the House of Representatives concurring, that the United States Department of Health and Human Services is urged to promote reproductive justice by amending its policies relating to postpartum sterilization waiting periods for Medicaid receipts; and

 

        BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the United States Secretary of Health and Human Services and Administrator of the Centers for Medicare and Medicaid Services.

 

 

 

	OFFERED BY:	_____________________________

Report Title:  

Postpartum Sterilization; Medicaid Reform.