Late Postpartum Coverage Loss Before COVID-19: Implications For Medicaid Unwinding

Abstract

Using unique Pregnancy Risk Assessment Monitoring System follow-up data from before the COVID-19 pandemic, we found that only 68 percent of prenatal Medicaid enrollees maintained continuous Medicaid coverage through nine or ten months postpartum. Of the prenatal Medicaid enrollees who lost coverage in the early postpartum period, two-thirds remained uninsured nine to ten months postpartum. State postpartum Medicaid extensions could prevent a return to prepandemic rates of postpartum coverage loss.

Exhibit 1

Percent of respondents with consistent insurance from pregnancy to the late postpartum period, by insurance type during pregnancy in 7 states, 10/2019–02/2020 Source: Authors’ analysis of data from PRAMS and the Opioid call-back survey from seven states: Kentucky, Louisiana, Massachusetts, Missouri, Pennsylvania, Utah, and West Virginia. Notes: Bar charts represent the % with consistent coverage type by prenatal coverage category.

Exhibit 2

Insurance continuity in the postpartum period, by insurance type during pregnancy in 7 states, 10/2019–02/2020 Source: Authors’ analysis of data from PRAMS and the Opioid call-back survey from seven states: Kentucky, Louisiana, Massachusetts, Missouri, Pennsylvania, Utah, and West Virginia. Notes: Pregnancy coverage comprises the % of the sample with private, Medicaid, or no coverage during prenatal care receipt. Early postpartum and late postpartum coverage is shown as a % of each pregnancy coverage category.