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House Ways and Means Committee Discusses Maternal Mortality

May 17, 2019—The House Ways and Means Committee convened witnesses at a May 16 hearing to discuss solutions to addressing the rising number of maternal deaths in the United States.

Chair Richie Neal (D-Mass.) opened the hearing by expressing urgency at the nearly 700 women who die every year as a result of pregnancy-related complications. He also noted that black, American Indian, and Alaska Native women are three times as likely as white women to as a result of childbirth. He stated that, “Congress has the tools to make a real change in maternity care, and eradicate these disparities, lower the maternal mortality rate, and save lives.” Neal also mentioned sociodemographic disparities in maternal deaths.

Ranking Member Kevin Brady (R-Texas) agreed with Neal, and said that, “for all women today, they are more at risk of dying when giving birth than their mothers were.” He also highlighted that “the statistics are even more alarming for women of color. African American women are three to four times more likely to experience pregnancy-related deaths than Caucasian women.”

The witnesses at the hearing urged Congress to develop a national strategy to address maternal mortality, and to continue research on the topic. Michael Lu, senior associate dean for academic, student, and faculty affairs at the Milken Institute School of Public Health at the George Washington University, said that a national strategy to eradicate maternal mortality is long overdue, and that we need to make “sure that we are aligning the right resources with the strategy.”

Many of the witnesses emphasized a need to recognize and confront institutional biases that put mothers’ lives in danger. Patrice A. Harris, MD, president-elect of the American Medical Association (AMA) stated that, “birth inequities arise at the intersection of discrimination by race and gender for black and Native American women … At the provider and institutional levels, there is a growing body of evidence demonstrating that implicit and explicit biases exist that negatively impact the quality of health care equity and patient safety and drive these inequities.”

She also highlighted AMA’s support for establishing government-funded maternal mortality review committees (MMRCs), stating that, “MMRCs are a critical first step in efforts to make pregnancy safer.” She also thanked Congress for passing the Preventing Maternal Deaths Act (P.L. 115-344), which was enacted last year.

Harris mentioned AMA and UnitedHealthcare’s recent letter to the ICD-10 Coordination and Maintenance Committee that urged them to expand Z-codes to diagnose patient social risk. The AAMC also submitted a letter of support, which states that “the addition of the proposed ICD-10-CM codes as an opportunity to collect more data that can improve outcomes by identifying specific barriers to care, and for appropriate risk adjustment to fully capture [social determinants of health] factors.”

Rep. Adrian Smith (R-Neb.) emphasized the gaps that occur in rural areas and asked the panel about telehealth as a way to increase health care access. Loren Robinson, deputy secretary for health promotion and disease prevention for the Pennsylvania Department of Health, said telehealth consultations can be particularly helpful in determining if a woman needs to access care from a doctor. She asked, “What is it that a mother or a pregnant woman is in need of? It may not be that she needs to go to the hospital. It may be that she has a concern about accessing child care.”

Members of the Committee largely agreed that something needed to be done about the increasing rates of maternal death, with Rep. John Larson (D-Conn.) stating that, “If this isn’t a call to arms, I don’t know what is.”

Contact:

Allyson Perleoni
Senior Legislative Analyst
Telephone: 202-862-6042
Email: aperleoni@aamc.org

Philip M. Alberti, PhD
Senior Director, Health Equity Research and Policy
Telephone: 202-828-0522
Email: palberti@aamc.org

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Jason Kleinman
Senior Legislative Analyst, Govt. Relations
Telephone: 202-903-0806
Email: jkleinman@aamc.org