Changes in insurance coverage for women after giving birth during a pandemic

“Studies show that the postpartum period is usually a time of increased insurance instability, mainly because people [with] Medicaid pregnancy coverage loses eligibility 60 days after birth, “said lead researcher Erica Eliasson, Ph.D., postdoctoral fellow in health services, policy and practice at Brown University School of Public Health in Providence, Rhode Island. . “As a result, individuals must be eligible for parental Medicaid to maintain Medicaid coverage after this period, which has more restrictive income requirements, or find alternative insurance options.

The change in the eligibility of insurance leads to a high degree of non-insurance in the postpartum period for those who had Medicaid-related pregnancy coverage, according to Eliasson. “However, in order to promote access to insurance during the COVID-19 public health emergency, there was a change in Medicaid’s policy that froze write-offs, which meant that anyone who would lose their Medicaid rights would no longer makes it.”

Medicaid’s pandemic policy has inspired authors to study changes in Medicaid’s eligibility after birth, “which is of recent political interest at the state and national levels,” Eliasson said. Modern obstetrics / gynecology®.

Researchers have collected data from the current population survey for 2019-2021, an annual social and economic supplement. Among 4,448 post-birth respondents, the transition from insured to uninsured decreased by 1.3%, from 3.1% in 2019 (before the pandemic) to 1.8% during the pandemic in 2021. The results show no other significant changes in coverage in general.1

In 2019, 88.2% of Medicaid-born respondents in the previous year had permanent Medicaid coverage, while 10.3% lost coverage and 1.6% switched to private coverage.

In 2021, Medicaid’s permanent coverage increased by 6.8% and the outflow of Medicaid uninsured decreased by 6.6%, down 64% from 2019.

In 2019, 97.1% of all respondents after the birth with private coverage in the previous year also maintained permanent private coverage, while 1.4% had a refusal of private medicine and 1.3% lost coverage.

Compared to 2019, the withdrawal of private medics has increased by 1.5% in 2021.

“The findings were largely what we expected,” Eliasson said. “Although the pandemic policy was not specific to promoting postpartum Medicaid, we expected there to be improvements in postpartum Medicaid, as so many of them lost Medicaid coverage during this period before the policy change.

Eliasson noted that increasing continuing postpartum coverage should provide improved access to postpartum care, “but this policy change occurred during the pandemic, which other studies have led to reduced use of health care, so it may not be achieved the same improvements in postpartum access to care that would have occurred had it not been for the pandemic, ”she said.

“Individuals may not have known they were insured and as a result may not have seen an improvement in access to postpartum care,” Eliasson said.

The change in Medicaid’s pandemic policy continues to continue, but is currently expiring in July 2022. “When this policy is repealed, those postpartum Medicaid-related maternity coverage would cease 60 days after birth will lose this Medicaid coverage, ”Eliasson said,“ and “we could see a large number of people who had stable Medicaid during the pandemic, suddenly uninsured.”


  1. [ PubMed ]Eliason EL, Daw JR, Steenland MW. Changes in postpartum insurance coverage in the United States during the COVID-19 pandemic. JAMA Health Forum. Published online on April 22, 2022 doi: 10.1001 / jamahealthforum.2022.0688

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