Sarah H. Gordon ( gordonsh@bu. edu ) is an assistant professor in the Department of Health Law, Policy, and Management, Boston University School of Public Health, in Massachusetts.
Benjamin D. Sommers is a professor of health policy and economics in the Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, and a professor of medicine at Brigham and Women's Hospital, both in Boston.
Health Aff (Millwood). 2020 Jan;39(1):77-84. doi: 10.1377/hlthaff.2019.00547.
Timely postpartum care is associated with lower maternal morbidity and mortality, yet fewer than half of Medicaid beneficiaries attend a postpartum visit. Medicaid enrollees are at higher risk of postpartum disruptions in insurance because pregnancy-related Medicaid eligibility ends sixty days after delivery. We used Medicaid claims data for 2013-15 from Colorado, which expanded Medicaid under the Affordable Care Act, and Utah, which did not. We found that after expansion, new mothers in Utah experienced higher rates of Medicaid coverage loss and accessed fewer Medicaid-financed outpatient visits during the six months postpartum, relative to their counterparts in Colorado. The effects of Medicaid expansion on postpartum Medicaid enrollment and outpatient utilization were largest among women who experienced significant maternal morbidity at delivery. These findings provide evidence that expansion may promote the stability of postpartum coverage and increase the use of postpartum outpatient care in the Medicaid program.
及时的产后护理与降低产妇发病率和死亡率相关，但接受产后访视的 Medicaid 受益人的比例还不到一半。由于与妊娠相关的 Medicaid 资格在分娩后 60 天后终止，因此 Medicaid 参保人面临更高的产后保险中断风险。我们使用了 2013-15 年科罗拉多州（该州根据《平价医疗法案》扩大了 Medicaid 覆盖范围）和犹他州（未扩大 Medicaid 覆盖范围）的 Medicaid 索赔数据。我们发现，在扩大 Medicaid 覆盖范围后，与科罗拉多州的对应人群相比，犹他州的新妈妈在产后六个月内 Medicaid 保险覆盖范围丧失的比例更高，获得的 Medicaid 资助的门诊就诊次数也更少。在分娩时经历严重产妇发病率的妇女中， Medicaid 扩张对产后 Medicaid 参保率和门诊利用率的影响最大。这些发现为以下观点提供了证据，即扩张可能会促进产后保险的稳定性，并增加 Medicaid 计划中产后门诊护理的使用。
