A federal policy requiring states to keep Medicaid beneficiaries enrolled during the COVID-19 pandemic extended postpartum Medicaid coverage nationwide and significantly increased the number of individuals remaining insured after childbirth, according to a Rutgers Health researcher on April 13.
The extension of postpartum Medicaid coverage is important because it aimed to improve health outcomes for new mothers and their babies by maintaining insurance beyond pregnancy. However, the actual impact on healthcare use appears mixed.
An analysis published in TheMilbank Quarterly reviewed Medicaid claims from 15 states and found that while more people kept their insurance—rising from 37% before the Families First Coronavirus Response Act to 77% during its implementation—there were only modest changes in how these individuals used healthcare. The study noted increases in emergency department visits and mental or behavioral health diagnoses among postpartum individuals, but did not find statistically significant changes in outpatient visits or pregnancy-related diagnoses. For example, emergency department use rose by about 107 visits per 1,000 beneficiaries during the three- to twelve-month postpartum period when extended eligibility was available.
Eliason said it is difficult to determine whether beneficiaries sought care outside Medicaid, whether awareness of continued coverage influenced care-seeking or how pandemic-related service disruptions shaped overall care utilization.
The authors stressed that extending postpartum coverage should be paired with communication efforts so that individuals are aware of and able to use their benefits. "I would advise policymakers that continuous postpartum coverage is an important tool for states to monitor and improve health outcomes for postpartum people and their babies," Eliason said. "But without strong communication and support, expanded eligibility may not fully translate into improved access or outcomes."
Researchers at Rutgers and the University of Maryland called for further studies looking at long-term effects on different populations under more stable public health conditions.
