Doctors Urge Governor to Reconsider Cuts to Maternal Mental Health Care

Doctors and women’s health advocates say they are “alarmed” and “disheartened” by Gov. Gavin Newsom’s decision to rollback his promise of health coverage for low-income women who are diagnosed with postpartum depression or anxiety.

It was one of many cuts to mental health funding the governor proposed in his revised budget to close the $54 billion shortfall created by the coronavirus pandemic, which psychologists now say will likely be followed by a mental health pandemic.

“Two-thirds of minimum wage jobs are held by women, who are at risk of losing those jobs and childcare and are under enormous distress,” said Joy Burkhard, executive director of 2020 Mom, an advocacy group for maternal mental health. “We know that this population is at extreme risk for maternal mental health disorders.”

Burkhard’s group helped pass a state law in 2018 that now requires doctors to screen new moms for postpartum depression and anxiety. Obstetricians soon noticed that the moms who were most vulnerable to the conditions were low-income women covered by Medi-Cal – half of all births in California are covered by the state’s Medicaid program.

But pregnancy-related Medicaid coverage ends six weeks after the baby is born.

“Doctors were left in a precarious position to not be able to treat the disorder that they were identifying,” Burkhard said.

Last year, Governor Gavin Newsom agreed to change that. He allotted $34 million for the 2020 fiscal year budget so that women who were diagnosed with a maternal mental health disorder could stay on Medi-Cal for up to 12 months to get treated.

Now he’s taking it back.

“Nothing breaks my heart more than making budget cuts,” Newsom said at a press conference discussing his revised budget proposal on Thursday. “Because one thing I know about cuts: there’s a human being behind every single number.”

Legislators will now negotiate with the governor on how to balance the state’s finances, with a final budget due in June.

Doctors who lobbied for the extended Medi-Cal benefits are already urging the governor to reconsider the cuts, particularly in light of the nation’s longstanding and “unacceptable” maternal mortality crisis.

“Denying postpartum Medicaid coverage to new moms who face mental health concerns will exacerbate that crisis,” said Dr. Laura Sirott, state chair of the American College of Obstetricians and Gynecologists, or ACOG.

“With all the signs of a behavioral health pandemic now on the horizon, our state must summon the resources and the resolve to ensure the very same vulnerable Californians we spared from the coronavirus now have our support to recover from its emotional aftermath.”

Mental health problems are one of the leading causes of maternal mortality. Sirott points to CDC data that shows all pregnancy-related suicides and unintentional drug overdoses were deemed preventable.

The looming mental health crisis is preventable, too, advocates say, if the state is willing to ensure safety net programs can meet the increased demand for depression, anxiety and substance abuse treatment.

“To get ready for the COVID-19 pandemic, California took unprecedented action to prepare our hospitals, shelter in place, and mobilize a massive public health response,” said Michelle Doty Cabrera, executive director of the County Behavioral Health Directors Association. “With all the signs of a behavioral health pandemic now on the horizon, our state must summon the resources and the resolve to ensure the very same vulnerable Californians we spared from the coronavirus now have our support to recover from its emotional aftermath.”