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Member Research and Reports

Member Research and Reports

BU: Medicaid Expansion Improves Access to Postpartum Care

A new study led by a Boston University School of Public Health researcher finds new mothers in a state that expanded Medicaid (Colorado) were more likely to keep Medicaid coverage and access postpartum care than those in a similar state that had not expanded Medicaid (Utah).

The study, published in the journal Health Affairs, found this especially true for new mothers who had experienced pregnancy/childbirth complications.

“One third of maternal mortality occurs after delivery, so continuous access to care in the year after birth is critical,” says study lead author Dr. Sarah Gordon, assistant professor of health law, policy & management.

But Medicaid policies in many states create a postpartum coverage “cliff,” she explains: “Medicaid eligibility for pregnancy ends 60 days after delivery, and income limits for parental Medicaid coverage typically fall far below income limits for pregnancy Medicaid coverage, resulting in high rates of postpartum coverage loss.” Medicaid expansion can narrow that gap.

Dr. Gordon and colleagues analyzed 2013-2015 Medicaid claims data from Colorado (which expanded Medicaid in 2014) and Utah (which would expand Medicaid in 2019).

The researchers found that Colorado and Utah had similar trends in 2013, but, after Colorado expanded Medicaid, new mothers in Colorado kept their coverage for an average of one month longer than new mothers in Utah. New mothers in Colorado also had 0.52 more Medicaid-financed outpatient visits in the six months after delivery than in Utah. Among new mothers who had severe complications at the time of childbirth, Medicaid-financed outpatient visits tripled in Colorado after expansion, and were 50 percent higher in post-expansion Colorado than in Utah.

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