Medicaid’s New Option to Extend Postpartum Coverage for 12 Months Could Prevent Hundreds of Thousands of Enrollees from Losing Coverage in the Months After Delivery

A brand new KFF evaluation finds that a whole bunch of hundreds of individuals are disenrolled from Medicaid every year after giving delivery, which could possibly be prevented if all states had been to take up a brand new possibility to increase Medicaid postpartum protection to 12 months.

The estimate – based mostly on evaluation of Medicaid claims information from 2018 – finds that 610,000 postpartum girls had been disenrolled inside a yr of giving delivery, accounting for about 40 p.c of the 1.5 million Medicaid enrollees with reside births that yr. A brand new federally funded state possibility to increase postpartum care was created by a provision within the American Rescue Plan Act of 2021. The brand new possibility took impact on April 1, 2022 and is accessible to states for 5 years. 

The choice – adopted by 33 states thus far and the main target of pending laws in a single different – is receiving renewed consideration amid rising maternal mortality charges and following the Supreme Courtroom’s resolution to overturn Roe v. Wade. State coverage choices about Medicaid postpartum protection could possibly be particularly impactful in states set to limit abortion entry, because the excessive court docket’s ruling might have an effect on the variety of births within the U.S. coated by Medicaid. Federal legislation solely requires states to supply pregnancy-related Medicaid protection by 60 days following childbirth, after which some enrollees could lose protection if their revenue is just too excessive to qualify for Medicaid by another eligibility pathway.

KFF researchers discover that amongst Medicaid enrollees with a reside delivery in 2018, 31 p.c had been disenrolled inside six months after supply and 40 p.c had been disenrolled inside a yr. Amongst those that had been disenrolled inside a yr, 1 in 4 (26%) subsequently re-enrolled in Medicaid throughout that very same 12-month interval following supply. This phenomenon, generally known as “churn,” can typically point out that administrative boundaries, quite than ineligibility, had been behind the protection loss.

There have been huge variations in disenrollment charges throughout states in 2018, as a result of large variation in states’ revenue eligibility limits and administrative necessities. For example, 89 p.c of Medicaid enrollees in Texas with a reside delivery that yr had been disenrolled throughout the 12 months following supply, in comparison with 9 p.c of enrollees in Washington D.C.

KFF analysts additionally discovered that disenrollment charges had been twice as excessive in states that had not carried out the Inexpensive Care Act’s Medicaid growth. Sixty-one p.c of postpartum Medicaid enrollees misplaced protection inside a yr after supply in non-expansion states, in comparison with 29 p.c in growth states.

The consequences of the brand new possibility to increase Medicaid postpartum protection for 12 months is not going to be felt till the tip of the pandemic-era steady enrollment requirement in Medicaid. It requires states to supply steady protection for Medicaid enrollees till the tip of the month by which the general public well being emergency (PHE) ends in change for enhanced federal Medicaid funding for states in the course of the COVID-19 emergency. The continual enrollment requirement has helped stop protection loss and churn amongst enrollees, together with postpartum enrollees, in the course of the pandemic.

For extra information and analyses about Medicaid postpartum protection and girls’s well being, go to

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