Human needs advocates have yet to unpack every last detail included in the recently approved fiscal year 2023 appropriations package, which Congress passed shortly before recessing for the December holidays. 

The legislation, which when introduced was 4,155 pages in length, includes several hard-fought measures for pregnant workers and new moms that please labor and health care advocates. 

One provision, the Pregnant Workers Fairness Act, was cosponsored by Sens. Bob Casey (D-PA) and Bill Cassidy (R-LA) and passed in the Senate on a bipartisan vote of 73 to 24. The measure, which labor advocates had spent ten years advocating for, would prevent employers from forcing pregnant workers out of their jobs, or denying reasonable accommodations so they can maintain healthy pregnancies while they continue to work. Cassidy said on the Senate floor that the legislation is “pro-family, pro-mother, pro-baby, pro-employer, and pro-economy.” 

“If a woman requests a stool to sit on or bathroom breaks, or a water bottle, even accommodations that are that simple, that basic and the subject of so much consensus — employers don’t have to provide those right now,” Casey said in an interview after the vote. 

Another measure included in the year-end spending package that pleased labor and health care advocates was the Providing Urgent Maternal Protections for Nursing Mothers, or PUMP Act. This provision requires organizations to provide time and space for breastfeeding parents. According to Forbes magazine, the Affordable Care Act of 2010 already required that employers provide reasonable time to express breast milk and provide a place for pumping, other than the bathroom, that is shielded from view and private. 

But, Forbes wrote, “the previous pumping law excluded most salaried employees, and the PUMP Act will extend these rights to all breastfeeding employees for the first year of the baby’s life.” 

The appropriations also included good news for children and moms on the health care front – permanent provisions that require states to provide 12 months of continuous Medicaid or Children’s Health Insurance Program eligibility for children and give states the option of providing 12 months of postpartum coverage. According to the Center on Budget and Policy Priorities, the American Rescue Plan gave states the option to provide 12 months of coverage, much more than the previous requirement of 60 days. But that provision was going to end after five years – it is now permanent.  

“Requiring all states to provide this coverage would have been a better outcome, particularly given the nation’s high and alarming rates of maternal and infant mortality,” CBPP wrote. “But knowing this coverage option is permanent could help encourage the holdout states to act on this policy.” The 12-months of eligibility for children means that states will not be allowed to require burdensome documentation from families before the end of that period to keep their children enrolled.  According to CBPP, 33 states plus Washington, D.C. have taken advantage of the year-long provision included in the Affordable Care Act. CBPP says extending coverage to a full year is “a critical step for addressing stark differences in maternal mortality across lines of race and ethnicity and, in particular, the very high rates of mortality among Black women stemming largely from structural racism in our health and economic systems.”  

While other maternal health provisions sought by advocates did not make it into the omnibus and the good things included were paid for by regrettable restrictions in Medicaid, the help that was included is significant.