Study Examines Impact of Medicaid Expansion on Postpartum Care

A study of postpartum care in two states found that Colorado’s 2014 Medicaid expansion improved postpartum coverage retention and access to outpatient care among new mothers compared with Utah, which did not expand Medicaid. Using Medicaid claims data from 2013 to 2015, researchers found the impact of Medicaid expansion was largest among women who had significant complications during delivery. New mothers in Colorado with complications had nearly 50 percent more postpartum Medicaid-financed outpatient visits compared with similarly complicated deliveries in Utah. Researchers noted Utah expanded its Medicaid program through the Affordable Care Act following the passage of a 2018 ballot initiative. Access the abstract of the study, published in the journal Health Affairs.

Effects Of Medicaid Expansion On Postpartum Coverage And Outpatient Utilization

Sarah H Gordon 1, Benjamin D Sommers 2, Ira B Wilson 3, Amal N Trivedi 4

Affiliations

PMID: 31905073
DOI: 10.1377/hlthaff.2019.00547

Abstract

Timely postpartum care is associated with lower maternal morbidity and mortality, yet fewer than half of Medicaid beneficiaries attend a postpartum visit. Medicaid enrollees are at higher risk of postpartum disruptions in insurance because pregnancy-related Medicaid eligibility ends sixty days after delivery. We used Medicaid claims data for 2013-15 from Colorado, which expanded Medicaid under the Affordable Care Act, and Utah, which did not. We found that after expansion, new mothers in Utah experienced higher rates of Medicaid coverage loss and accessed fewer Medicaid-financed outpatient visits during the six months postpartum, relative to their counterparts in Colorado. The effects of Medicaid expansion on postpartum Medicaid enrollment and outpatient utilization were largest among women who experienced significant maternal morbidity at delivery. These findings provide evidence that expansion may promote the stability of postpartum coverage and increase the use of postpartum outpatient care in the Medicaid program.

Keywords: Access and use; Access to care; Affordable Care Act; Health policy; Maternal health; Medicaid; Medicaid coverage; Medicaid eligibility; Morbidity; Mortality.