Clark gears up federal machinery on postpartum depression treatment

In June, the Baker administration mandated postpartum depression screening for MassHealth patients, making it one of only a handful of states that screen Medicaid recipients for the condition.

But what the Commonwealth giveth, it can taketh away. Several weeks after Lt. Gov. Karyn Polito shocked community advocates and health care professionals with the MassHealth decision, Gov. Charlie Baker vetoed $200,000 in fiscal 2016 spending for a postpartum depression screening pilot program in Holyoke, Lynn, Jamaica Plain, and Worcester.

The Baker administration may have reckoned that many women in the four communities would be identified and treated under the new MassHealth screening regime. But it put administration officials in the awkward position of sending out conflicting signals on postpartum depression treatment and research.

Enter US Rep. Katherine Clark. This week, the Massachusetts Democrat parachuted in with the “Bringing Postpartum Depression Out of the Shadows Act,” which would appropriate $5 million per year for fiscal years 2016 through 2020 for programs designed to identify and treat the condition.

Clark recruited Rep. Ryan Costello, a Republican who represents a suburban Philadelphia congressional district, to co-sponsor the bill. Costello, a first-term congressman, is a relatively new lawmaker like Clark who is committed to breaking DC deadlock. (Note the purple tie.)

“Politics is the art of persuasion and getting people to move to your position,” Costello told Red Alert Politics before his November 2014 election victory. “If you are not open-minded, and you are not looking to persuade people in a respectful way then all you are doing is being a talking head. If I wanted to be a talking head, I’d be in a different profession.”

Team Clark-Costello also secured the support of the American Congress of Obstetricians and Gynecologists, the American Academy of Pediatrics, and the American Psychological Association. The national obstetricians and gynecologists association’s support was an especially good get as the group only recently signaled measured support for screening efforts.

Early detection and treatment strategies have been difficult to implement: Many doctors were reluctant to screen women who might be suffering from postpartum depression since they were unsure of how to treat depression in pregnant and postpartum women.

Federal action on postpartum depression has only begun to ramp up in the past several years. The Affordable Care Act contains provisions to promote research and related programs. But it’s anyone’s guess what the consensus-averse Republican House will do with a bill that would send federal funds monies to states to further the goals of Obamacare.

Until very recently, postpartum depression was largely unknown and widely misunderstood. Indeed, postpartum depression runs along a spectrum that ranges from mild to severe. Most cases respond to medication or talk therapy. Yet, it was the rare but extreme cases of mothers killing themselves or their children that riveted the public.

Working on postpartum depression grant funding with a fellow junior colleague may not be on a par with saving the American financial system from collapse. But it is another skillful move for a lawmaker like Clark, who is trying to dent a political culture obsessed with obstruction over compromise.

Plus, Clark’s legislation might wind up producing a few hundred thousand dollars for future treatment and research in the Bay State. As Peter Ubertaccio, a Stonehill College political science professor, recently told CommonWealth, Clark “is really trying to work across the aisle, and to do that you are going to start with smaller, more pragmatic bills.”




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