Postpartum Medicaid Coverage Expansion and Changes in the Risk of Health Insurance Loss Within the Second Year After Birth

Popul Health Manag. 2025 Nov 13. doi: 10.1177/19427891251393727. Online ahead of print.

Abstract

To determine whether pandemic-era Medicaid policies to increase postpartum coverage to 1 year were effective in preventing coverage loss into the second-year postpartum. The analytic sample included 7967 cases (N = 4632 in the pandemic era) from the 2019 and 2021-2024 Current Population Survey, Annual Social and Economic Supplement. On multivariable analysis of the entire sample, era was not associated with the type or continuity of insurance coverage. Among families living below 100% Federal Poverty Level, the relative risk of coverage gaps compared with continuous private coverage decreased by 58% (95% confidence interval: 19%, 79%, P = 0.010). Pandemic-era Medicaid policies appeared effective in preventing postpartum coverage loss in the second year after birth, especially among families living below the poverty line.

Keywords: COVID-19; Medicaid; insurance; pandemic; postpartum.