Columbia Mailman School of Public Health: ACA Medicaid Expansion Improves Insurance Coverage for Pregnant People

NEW YORK, January 6 (TNSJou) – from Columbia University Mailman School of Public Health published the following news:

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The results are relevant to the postpartum Medicaid arrangements in the we Rebuild Better Act

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According to a study conducted at Columbia University Mailman School of Public Health. However, there was limited evidence that the expansion of Medicaid increased the use of perinatal health care or improved infant birth outcomes overall. The results are published in the January 2022 issue of the journal Health Affairs.


“In previous research before ACA, we found high rates of uninsured among women of reproductive age,” said Jamie daw, PhD, Columbia Mailman School assistant professor of health policy and management and senior author. “Furthermore, the rate of insurance churn – switching from insurance to uninsured or changing insurer – was common around pregnancy, and high rates of coverage instability may have contributed to less access to care and poorer maternal and child health outcomes. The result had a disproportionate impact on the low – income earners and members of racial and ethnic minority groups who qualify for Medicaid coverage during pregnancy. “

Drawing on original, peer-reviewed quantitative research studies, Daw and colleagues systematically analyzed published data between January 2014 and April 2021. They looked at the effect of the ACA’s state Medicaid extensions on insurance coverage, health care utilization, and health outcomes measured between one month before conception and one year after birth. childbirth, and neonatal outcomes within twenty-seven days of birth. The researchers identified 35 unique studies that met their selection criteria.

Increases in Medicaid coverage have been larger during preconception and postpartum periods than during childbirth, because pregnant women were already eligible for Medicaid from conception to sixty days after birth before ACA.

“Despite a large increase in coverage before and after pregnancy, we found limited evidence that the expansion of ACA Medicaid improved overall perinatal health care use or health outcomes in the first years after. implementation ”, noted Meghan bellerose, ’21 MPH, doctoral student at Brown University School of Public Health and first author. However, one study found that the expansion of ACA Medicaid was associated with a reduction in racial disparities in childbirth outcomes such as preterm birth, and another found a reduction in overall maternal mortality. These results are promising and deserve to be explored further because the we continues to pursue strategies to reduce racial disparities in maternal mortality and morbidity. “

“Our results indicate that extending Medicaid to low-income adults is a very effective approach to increasing pre-conception and postpartum health insurance coverage,” Daw said. “Our ability to observe corresponding changes in health care use and outcomes is in part linked to a lack of data collection on pre-conception and postpartum outcomes in the we Our findings are highly relevant to the recent call to action on maternal health care launched by the White House and the postpartum Medicaid provisions under the Build Back Better Act, suggesting that these provisions will lead to significant coverage gains, but more data will be needed for a rigorous assessment of the impact of Medicaid policy changes on. disparities in maternal health. “

A co-author is Lauren Collin of Columbia Mailman School.

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JOURNAL link: Health affairs –

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Justin D. O'Neill