Maternal mortality rate remains high, but Joe Biden took steps to improve outcomes

The United States has had the highest maternal mortality rate among income-comparable countries for years — and this remains the case.

While campaigning for president in 2020, Joe Biden said he would "reduce our unacceptably high maternal mortality rate."

In 2022, the latest year with available data, 817 women in the U.S. died of maternal causes; a rate of 22.3 maternal deaths per 100,000 live births, according to the Centers for Disease Control and Prevention's National Center for Health Statistics. This compares with 1,205 maternal deaths in 2021 — a year with a spike in deaths primarily because of the COVID-19 pandemic — and 861 in 2020, 754 in 2019 and 658 in 2018.

We don't yet have data for Biden's last two years in office. And although 2022's rate is about the same as when Biden made his promise in 2020, maternal health experts said his administration worked to improve maternal care. 

The American Rescue Plan Act, which Biden signed into law in 2021, included a provision for states to extend Medicaid postpartum coverage to 12 months until May 2023. The 2022 Consolidated Appropriations Act that Biden signed in 2023 gave states the option to make the expansion permanent. Today, 43 states have Medicaid coverage until 12 months postpartum.

Maternal health experts said the administration's push to extend this coverage has been critical to making good on Biden's promise. Historically, the Medicaid program set the minimum eligibility for this coverage at 60 days after giving birth, though 53% of maternal deaths happen a week to a year after pregnancy.

Because the expansion is still relatively new, it's not yet possible to measure whether it has reduced postpartum hospitalizations and improved maternal mortality rates, experts said. But some preliminary studies have linked a reduction in postpartum hospitalizations to the Medicaid expansions.

In June 2022, Biden's administration also unveiled the White House Blueprint for Addressing the Maternal Health Crisis. The document included policy proposals such as the Medicaid postpartum expansion, and called for conducting more maternal health research and making investments into programs and training to address geographic, racial and ethnic disparities in maternal care.

In August, the U.S. Department of Health and Human Services announced $558 million in funding to improve maternal health. This includes $440 million to expand voluntary home visiting programs to improve maternal and child health and $118.5 million to improve public health infrastructure to better identify and prevent pregnancy-related deaths.

And in November, the Department of Health and Human Services, through the Centers for Medicare and Medicaid Services, announced new health and safety requirements for hospitals and "Critical Access Hospitals," a designation given to eligible rural hospitals, providing obstetrical services to make pregnancy, childbirth and postpartum care safer. The Centers for Medicare and Medicaid Services also said it was removing barriers to expand access to care for those formerly incarcerated and others in underserved communities.

The policies are included in the 2025 Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center final rule.

"CMS is committed to addressing our nation's maternity care crisis. Today, we are establishing the first-ever maternal health and safety standards for hospitals," Centers for Medicare and Medicaid Services Administrator Chiquita Brooks-LaSure said in a Nov. 1 news release. The final rule also "expands access to behavioral health services, Brooks-LaSure said.

Overall, maternal health experts said the U.S. hasn't seen a meaningful reduction in the maternal mortality rate. But they noted that the administration's focus on expanding postpartum health coverage and advancing training and data collection are significant steps toward making good on Biden's pledge. We rate this Compromise. 

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