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Title: Uninsured New Mothers' Health and Health Care Challenges Highlight the Benefits of Increasing Postpartum Medicaid Coverage
Citation Type: Miscellaneous
Publication Year: 2020
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Abstract: Alarming increases in US maternal mortality have generated national attention, a search for policy solutions to promote maternal health, and an increased recognition of how important the postpartum period is for mothers' and infants' health and well-being. Without access to consistent, comprehensive health insurance coverage, many new mothers can face extreme challenges obtaining the care they need to support their and their infants' health. This analysis uses 2015-18 data from the National Health Interview Survey (NHIS) to document access and affordability challenges facing uninsured new mothers and 2015-17 data from the Pregnancy Risk Assessment and Monitoring System (PRAMS), a state-specific surveillance system of pregnancies resulting in a live birth, to describe the health status of women who lost Medicaid coverage following their pregnancies. Together, our analysis provides new evidence on the access and affordability barriers that could be reduced and the health problems that could be treated if these uninsured new mothers were to gain coverage through a postpartum Medicaid extension or broader Medicaid expansion. Key Findings Approximately 11.5 percent of new mothers nationwide were uninsured from 2015 to 2018; just over half of those uninsured new mothers were Hispanic, and close to two-thirds lived in the South. About 1 in 5 uninsured new moms reported at least one unmet need for medical care because of cost in the past year, and over half were very worried about paying their medical bills. Roughly half of all uninsured new mothers reported that losing Medicaid or other coverage after pregnancy was the reason they were uninsured, suggesting that they would likely benefit from an extension of postpartum Medicaid coverage. Almost one-third of women who lost Medicaid coverage and became uninsured in the postpartum period were obese before their pregnancy, and 18 percent reported either gestational diabetes or pregnancy-related hypertension, all conditions that require ongoing monitoring and care after giving birth. About one-third of new moms who lost Medicaid were recovering from a cesarean section, and just over one-quarter reported being depressed sometimes, often, or always in the months after giving birth. Altogether, our findings indicate that many uninsured new mothers report trouble affording care and have both physical and mental health needs that would benefit from the more consistent access to coverage and care that expanding Medicaid would provide. These findings are particularly relevant given the COVID-19 pandemic and ensuing economic crisis, which will put even more women at risk of uninsurance and in need of affordable coverage options before, during, and after pregnancy.
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Authors: Mcmorrow, Stacey; Dubay, Lisa; Kenney, Genevieve M; Johnston, Emily M; Caraveo, Clara Alvarez
Publisher: Health Policy Center
Data Collections: IPUMS Health Surveys - NHIS
Topics: Population Health and Health Systems, Reproductive and Sexual Health
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