Rate of postpartum insurance loss decreases during COVID-19 pandemic

Compared with the pre-pandemic rate, the rate of postpartum insurance loss was significantly lower during the COVID-19 pandemic, largely due to increases in consistent Medicaid coverage, according to data in JAMA Health Forum.

Because pregnancy-related Medicaid coverage ends 60 days postpartum, pregnant people with Medicaid insurance often experience gaps in insurance coverage.

“These findings suggest that the Families First Coronavirus Response Act, which prevented Medicaid disenrollment, was associated with substantial reductions in postpartum Medicaid loss,” Erica L. Eliason, PhD, MPH, a postdoctoral research fellow at Brown University School of Public Health, and colleagues wrote.

Eliason and colleagues reviewed data from 4,448 postpartum participants who responded to the Current Population Survey, Annual Social and Economic Supplement (CPS-ASEC) between 2019 and 2021.

Respondents reported insurance coverage at the time of the survey and within the last calendar year. Using this information, the researchers examined changes in coverage for participants during the pre-pandemic (2019), early pandemic (2020) and pandemic (2021) years.

Data showed that the percentage of people who lost coverage decreased from 3.1% in 2019 to 1.8% in 2021.

For 2019 respondents with Medicaid within the last year, 88.2% remained on Medicaid, 10.3% lost coverage and 1.6% changed to private insurance. However, 2021 data showed that the percentage of people maintaining Medicaid coverage increased by 6.8 percentage points (95% CI, 1.7-11.9) and the percentage of those who lost Medicaid coverage decreased by 64% (–6.6 percentage points; 95% CI, –11.1 to –2).

Among privately insured respondents in 2019, 97.1% maintained coverage, 1.4% switched to Medicaid and 1.3% lost coverage. In 2021, the percentage of people who switched to Medicaid was 1.5 percentage points (95% CI, 0-2.9) higher than in 2019.

Although the study was limited by the nature of the CPS-ASEC, the findings revealed the importance of maintained insurance coverage following pregnancy.

“Taking insurance protection away 60 days postpartum means that a very sizable population will be without coverage during a vulnerable time in their lives, putting their health and that of their babies at higher risk,” Eliason said in a press release.

References:

• Postpartum insurance loss decreased during COVID-19 pandemic, study finds. https://www.eurekalert.org/news-releases/950317. Published April 22, 2022. Accessed April 27, 2022.
• Eliason EL, et al. JAMA Health Forum. 2022;doi:10.1001/jamahealthforum.2022.0688.