Postpartum insurance loss decreased during Covid pandemic, study finds

Brown researchers found that temporary changes to Medicaid eligibility meant that women who were due to lose coverage 60 days after giving birth were able to stay on their plans.

PROVIDENCE, R.I. [Brown University] - It's been the case for decades - high numbers of U.S. women who give birth lose or face changes to their health insurance afterward. And those with Medicaid benefits are most likely to lose coverage, because pregnancy-related Medicaid ends after 60 days postpartum, and eligibility for parents is much more restrictive.

However, significantly fewer people lost postpartum insurance during the COVID-19 pandemic, according to a new study in JAMA Health Forum. Compared to the prior year, consistent Medicaid coverage among postpartum participants actually increased during the pandemic.

The findings suggest that the Families First Coronavirus Response Act, which was signed into law in March 2020 and prevented Medicaid disenrollment, led to substantial reductions in postpartum Medicaid loss, said study author Erica Eliason, a postdoctoral researcher at Brown University's School of Public Health. This is significant, she said, because the act is set to expire in July 2022, and many states are considering legislation to extend pregnancy-related Medicaid through one year postpartum.

"The Coronavirus Response Act was a boon for families in that it allowed postpartum people on Medicaid to hold on to their health insurance," Eliason said. "Many people will lose postpartum Medicaid coverage when the public health emergency ends unless states decide to extend Medicaid for a full year after childbirth - which they currently have the option to do under the American Rescue Plan Act."

To examine postpartum insurance churn (insurance changes or coverage loss) during the pandemic, Eliason and Maria Steenland, a Brown assistant professor (research) of population studies, and Jamie Daw of Columbia University, analyzed data from the 2019-2021 Current Population Survey Annual Social and Economic Supplement, which is the source of official national estimates of poverty levels and rates and of widely used measures of income. They focused on reported insurance coverage of female respondents ages 18-44 who were living with a child younger than 1 year. They looked at postpartum insurance churn overall and by insurance type (Medicaid vs. private) during three time periods: pre-pandemic (2019), early pandemic (2020) and pandemic (2021).

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