For some women, consistent medical coverage does not begin until they become pregnant. When pregnant, health insurance is received through Medicaid or Marketplace to receive proper prenatal care for themselves and their babies. A new study shows that too many women are lacking medical coverage as a whole, however, one-in-three women lack Medicaid coverage before and after pregnancy.
According to a study conducted by the Urban Institute, researchers found that nearly 27 percent of women lacked medical coverage before becoming pregnant. After pregnancy, almost 22 percent of the same group of women became uninsured again.
The study, published in the journal, Health Affairs, found that overall, 34.5 percent of women surveyed did not have access to medical coverage either before or after pregnancy.
To determine who was covered, the study looked at data provided by Medicaid from 2015 through 2018. The information came from women who participate in the Pregnancy Risk Assessment Monitoring System (PRAMS).
According to Fierce Healthcare, PRAMS is offered in 43 states, including 27 that include expanded Medicaid under the Affordable Care Act. The expansion allows for those up to the age of 64 who have income up to 138 percent of the federal poverty level to be covered.
Unfortunately, not all states participate, and according to healthinsurance.org, leaving "a coverage gap" where 2.5 million people do not qualify for any health insurance at all.
Lawmakers have realized the benefits of ensuring that pregnant women have health insurance while expecting. That is why under the Affordable Care Act, Medicaid or the Health Insurance Marketplace are required to provide health insurance for those who are expecting, according to the March of Dimes. Unfortunately, the same cannot be said for postnatal care or care during the fourth trimester.
Women who were given health coverage through Medicaid or Marketplace are only covered for 60 days after delivering their baby. While this does cover a postpartum appointment to ensure that the new mother is physically healing properly after delivery, it does not allow for treatment for mental health, complications from a difficult pregnancy, family planning, and more, according to KFF.
Because of this, researchers said that women who were brought into the Medicaid program would benefit from expansion in all states that would allow them medical coverage for a year after giving birth.
For those who do not qualify for Medicaid, according to Fierce Healthcare, having "outreach and enrollment efforts for subsidized Marketplace coverage could help women not eligible for Medicaid identify affordable coverage options," per researchers.
While there have been gains by the requirement of women receiving some form of healthcare during pregnancy and a short period after delivery, according to Health Affairs, researchers state more needs to be done. They state that "further policy changes" are necessary to allow more women to be eligible for healthcare before pregnancy and after.
By expanding the requirements to make it so that women are covered for one year after giving birth, the fourth trimester would be covered and then women could make the transition into parental Medicaid or affordable insurance through Marketplace, allowing them to remain covered permanently.
Source: Fierce Healthcare, HealthAffairs, healthinsurance.org, KFF, March of Dimes