Loss of Pregnancy-Related Medicaid Coverage Is Associated With Unmet Need for Health Care, Medical Financial Hardship, and Lower Health Care Use in Postpartum Women.

Objectives: We examined the association of loss of pregnancy-related Medicaid coverage with unmet health care needs, medical financial hardship, and health care use in postpartum women participating in a nationally representative household survey.

Design: Cross-sectional study design.

Sample and measurements: Using 2012-2018 National Health Interview Survey data, we classified postpartum women as either (1) having Medicaid coverage or (2) uninsured due to loss of pregnancy-related Medicaid coverage. We examined the relationship of loss of pregnancy-related Medicaid coverage with unmet health care needs, medical financial hardship, and health care use.

Results: Compared to Medicaid-insured postpartum women, uninsured women who lost pregnancy-related Medicaid coverage had significantly greater odds of delaying medical care due to cost, as well as greater odds of unmet need for medical care, mental health care, and prescriptions. Uninsured postpartum women who lost pregnancy-related Medicaid coverage also had significantly greater odds of medical financial hardship and lower odds of health care use.

Conclusions: Findings suggest that continued Medicaid coverage during postpartum could improve health care access among uninsured women experiencing loss of pregnancy-related Medicaid eligibility. These results hold important implications for the public health impact of recent policy efforts to extend Medicaid eligibility into the postpartum period.