Medicaid coverage provides essential care during pregnancy. Expansion of the program can impact the number of poor mothers who have no health insurance.
Medicaid provides critical care in the perinatal period, but prior to the 2014 Medicaid expansions from the Affordable Care Act (ACA) the mother’s eligibility could extend only 60 days postpartum. A new study in Pediatrics looked at how the Medicaid expansion impacted the insurance coverage of new mothers who were living in poverty.1
Investigators defined a new mother living in poverty as a woman aged 19 to 44 years with an income below the federal poverty level who reported giving birth in the past 12 months. They used 2010-2017 American Community Survey data and difference-in-differences method using parental Medicaid-eligibility thresholds to approximate the effect of the ACA-related Medicaid expansion on insurance coverage.
They found that a 100-percentage-point increase in parental Medicaid eligibility is linked to an 8.8 percentage point decrease in uninsurance, a 13.2 percentage point increase in Medicaid coverage, and a 4.4 percentage point decrease in private or other form of coverage among new mothers in poverty. Overall, an average increase in Medicaid eligibility was tied to a 28% decrease in uninsurance, an 18% decline in private or other form of insurance, and a 13% increase in Medicaid coverage among new mothers living in poverty in states with Medicaid expansions.
There is still room to grow in both states that had Medicaid expansion and those that did not expand. In 2017, there were roughly 142,000 new mothers in poverty who were still uninsured.
1. Johnston EM, McMorrow S, Thomas TW, Kenney GM. ACA Medicaid expansion and insurance coverage among new mothers living in poverty. Pediatrics. 2020;145(5):e20193178. doi: 10.1542/peds.2019-3178