Dive Brief:
- Postpartum people are at risk of losing health insurance as states begin the process of redetermining Medicaid eligibility, according to a report out Friday by KFF.
- During the COVID-19 pandemic, states were required to keep Medicaid enrollees continuously enrolled in exchange for more generous federal funding. However, in April, states were allowed to begin disenrolling members who are no longer eligible or haven’t renewed coverage.
- Although Congress gave states the option to expand Medicaid coverage up to a year postpartum during the continuous enrollment period, not all states opted in, leaving some now vulnerable to losing coverage 60 days after giving birth.
Dive Insight:
Medicaid covers more than 40% of births in the U.S., with almost two out of three women in the program of reproductive age.
Although states are required to provide postpartum coverage up to 60 days after birth, health risks from pregnancy can continue long after coverage would expire. According to an analysis from the Centers for Disease Control and Prevention, which analyzed data from 36 states between 2017 and 2019, 30% of pregnancy-related deaths occurred in the late postpartum period, or between 43 and 365 days after giving birth.
Thirty-three states and the District of Columbia have extended Medicaid coverage up to a year after giving birth, and four additional states have pending legislation.
Another coverage risk for postpartum patients in states that haven’t expanded Medicaid include income requirements, which are much lower for parents than for pregnant enrollees. Some patients may fall into the Medicaid coverage gap, where they make too much to qualify for Medicaid coverage but not enough to receive Affordable Care Act exchange subsidies.
The KFF report noted that a single mother in Texas could lose her Medicaid coverage two months after giving birth if she has an annual income above $4,000, and she could fall into the coverage gap if her income is below $24,860.
Even if parents are still eligible for Medicaid, they may struggle to complete the renewal process. A recent KFF survey found around two-thirds of Medicaid enrollees weren’t sure whether states could now remove people from the program if they don’t meet eligibility requirements or haven’t renewed. Nearly half reported they hadn’t previously renewed their coverage.
