Insurance coverage

Study examines changes in postpartum insurance coverage in the United States during the COVID-19 pandemic

This has been the case for decades -; a large number of American women who give birth lose or face changes to their health insurance afterwards. And those on Medicaid benefits are the most likely to lose coverage because pregnancy-related Medicaid ends after 60 days postpartum and parental eligibility is much more restrictive.

However, far fewer people have lost postpartum insurance during the COVID-19 pandemic, according to new research from the JAMA Health Forum. Compared to the previous year, consistent Medicaid coverage among postpartum participants has actually increased during the pandemic.

The findings suggest that the Families First Coronavirus Response Act, which was signed into law in March 2020 and prevented Medicaid opt-out, resulted in substantial reductions in postpartum Medicaid losses, study author Erica Eliason said. , a postdoctoral fellow at Brown University’s School of Public Health. That’s important, she said, because the law is set to expire in July 2022, and many states are considering legislation to extend pregnancy-related Medicaid for up to a year after giving birth.

The Coronavirus Response Act has been a boon for families in that it has allowed postpartum people on Medicaid to keep their health insurance. Many people will lose postpartum Medicaid coverage when the public health emergency ends, unless states decide to extend Medicaid for a full year after childbirth -; which they currently have the ability to do under the American Rescue Plan Act.”

Erica Eliason, Postdoctoral Fellow, Brown University School of Public Health

To examine postpartum insurance rollover (changes in insurance or loss of coverage) during the pandemic, Eliason and Maria Steenland, Brown Assistant Professor (research) of Population Studies, and Jamie Daw of Columbia University, have analyzed data from the annual current population survey 2019-2021. Social and Economic Supplement, which is the source of official national estimates of poverty levels and rates and widely used income measures. They focused on the reported insurance coverage of respondents aged 18 to 44 who lived with a child under the age of one. They looked at overall insurance attrition postpartum and by type of insurance (Medicaid vs. private) over three time periods: pre-pandemic (2019), early pandemic (2020), and pandemic (2021).

The researchers found that among the sample, the insurance lapse rate fell from 3.1% in 2019 to 1.8% in 2021. In 2019 (before the pandemic), among respondents who reported having Medicaid in the past year, 88.2% had regular Medicaid, 10.3% lost coverage, and 1.6% switched to private coverage. In 2021 (during the pandemic), 95% had constant Medicaid, 3.7% lost coverage, and 0.8% moved to private coverage. The number of people who transitioned from Medicaid to uninsured has dropped by 64% during the pandemic.

Since decreases in postpartum insurance losses were primarily associated with large, consistent increases in Medicaid, the researchers said the findings suggest the Families First Coronavirus Response Act was a primary factor in the substantial reduction in Medicaid losses. postpartum.

That’s important because the postpartum period can present unique health risks, Eliason said. About 52% of maternal deaths in the United States occur during this time, she noted; moreover, complications (such as cardiovascular or metabolic) that were present during the pregnancy may persist and the risk of mental health problems may increase. Studies show that one in eight people who have recently given birth suffer from postpartum depression, which can lead to suicide or drug overdose, making mental health issues one of the leading causes of death in the postpartum period. -partum, Eliason said.

Women with health insurance, however, can be screened for mental and physical health issues and connected to appropriate resources and care. That’s why it’s so important that people be allowed to keep their health insurance coverage during this time and beyond, Eliason said, especially with Medicaid covering nearly half of all births in the United States. .

“Withdrawing insurance protection 60 days after giving birth means that a very large population will be without coverage during a vulnerable time in their lives, putting their health and that of their babies at greater risk,” he said. she stated.


Journal reference:

Eliason, E.L. et al. (2022) Changes in Postpartum Insurance Coverage in the United States During the COVID-19 Pandemic. JAMA Health Forum.