Medicaid Expansion Improved Insurance Stability for Low-Income Pregnant Women

When states expanded Medicaid eligibility, pregnant people were less likely to have disruptions in health care insurance around the time of pregnancy.

5:00 AM

Author | Beata Mostafavi

Pregnant women in hospital gown
Credit: Getty Images

Gaps in insurance coverage between preconception and after childbirth can significantly impact access to high quality health care and health outcomes – for both new moms and their babies.

And this "insurance churn" – moving between different insurance plans or insurance and un-insurance – is especially common among low income pregnant patients and women of color.

But when states expanded Medicaid eligibility, pregnant people were more likely to have continuous health insurance coverage, a new study in Health Affairs finds.

Researchers followed 47,617 pregnant people from 2012 to 2017, comparing outcomes in states that expanded Medicaid, an optional piece of the Affordable Care Act, and those that didn't.

MORE FROM THE LAB: Subscribe to our weekly newsletter

Medicaid expansion improved the stability of insurance coverage for low-income women in the months leading up to and right after their baby's birth. In states that expanded coverage, pregnant people's likelihood of losing insurance in the perinatal period dropped by 10 percentage points.

"Insurance disruptions particularly affect women who are low-income, are racial and ethnic minorities, and who have chronic health conditions. These populations are also at highest risk of pregnancy-related complications and deaths," says senior author Lindsay Admon, M.D., M.Sc., an obstetrician-gynecologist at Michigan Medicine Von Voigtlander Women's Hospital.

"Perinatal insurance eligibility expansions may be a powerful strategy for reducing the high rates of maternal morbidity and mortality in the United States."

The U.S. is one of the only developed countries with a rising maternal mortality rate, and the Centers for Disease Control and Prevention has identified lack of access to quality healthcare as a key contributor to pregnancy-related deaths.

Perinatal insurance eligibility expansions may be a powerful strategy for reducing the high rates of maternal morbidity and mortality in the United States.
Lindsay Admon, M.D., M.Sc

The most common cause of maternal death in the country is complications occurring as a result of a mother's pre-existing, chronic condition.

Admon's previous research shows disruptions in insurance coverage also disproportionately affect racial and ethnic minority women before, during and after pregnancy.

LISTEN UP: Add the new Michigan Medicine News Break to your Alexa-enabled device, or subscribe to our daily updates on iTunes, Google Play and Stitcher

Stabilizing insurance for low-income women can improve access to the care women need to avoid adverse events during pregnancy and postpartum, authors say.

"Insurance loss and change is common during the perinatal period because changes in employment, income, marital status, and Medicaid eligibility, often go hand-in-hand with pregnancy and childbirth," says lead author Jamie Daw, Ph.D., assistant professor of Health Policy and Management at Columbia Mailman School. "We find that Medicaid expansion stabilizes insurance for low-income women, which can improve access to the care women need to support their health and avoid adverse events during pregnancy and postpartum."

Paper cited: "Medicaid Expansion Improved Perinatal Insurance Continuity for Low-Income Women," Health Affairs. DOI: 10.1377/hlthaff.2019.01835


More Articles About: Rounds Pregnancy Pregnancy Complications childbirth High-Risk Pregnancy Caesarean Section Labor Von Voigtlander Women's Hospital Womens Health obstetrics
Health Lab word mark overlaying blue cells
Health Lab

This article is from the Health Lab digital publication.

Media Contact Public Relations

Department of Communication at Michigan Medicine

MichMedmedia@med.umich.edu

734-764-2220

Newsletter

Get a weekly digest of medical research and innovation, straight to your inbox.

Subscribe
Featured News & Stories Nurses looking at clipboard with goggles and masks on in clinic
Health Lab
A dual approach to nursing shortages
An education and employment partnership seeks to fill a need for more nurses while also supporting a diverse workforce.
pregnant stomach with yellow dots and blue undertone lab note
Health Lab
Few pregnant people who died of overdose, suicide in Michigan received proper treatment before death
A review of maternal deaths suggests most individuals had documented behavioral health conditions but only one-third received appropriate pharmacologic treatment before death
substance use treatment map usa substance use treatment facilities not providing services in sign language <20.0% 20.0%-29.9% 30.0%-39.9% 40%-49.9%
Health Lab
Mental health, substance abuse treatment facilities don't provide communication access to Deaf, Hard of Hearing patients
These services, researchers found, were largely inaccessible to people who use sign language, discriminating against already ‘severely marginalized’ population in the United States.
blue cells, gut with sushi, face mask and more in a collage
Health Lab
Michigan Health Lab’s most read articles of 2022
The year provided one fascinating research story after another.
doctor talking to patient in clinic with blue shirt
Health Lab
For antiphospholipid syndrome patients, lab results don’t always paint the full picture
Patients with APS have concerns about their ability to function normally, even when their blood work and clinical visits appear normal.
depiction of a woman top and bottom and uterus in middle and red all over and crying sad
Health Lab
Is it PMS or premenstrual dysphoric disorder?
For some women, it’s more than just premenstrual symptoms.&nbsp;