Division of Health Policy and Management, Rural Health Research Center, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA.
Department of Obstetrics and Gynecology, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA.
J Womens Health (Larchmt). 2022 Oct;31(10):1397-1402. doi: 10.1089/jwh.2022.0169. Epub 2022 Aug 30.
Half of maternal deaths occur during the postpartum year, with data suggesting greater risks among Black, Indigenous, and people of color (BIPOC) and rural residents. Being insured after childbirth improves postpartum health-related outcomes, and recent policy efforts focus on extending postpartum Medicaid coverage from 60 days to 1 year postpartum. The purpose of this study is to describe postpartum health insurance coverage for rural and urban U.S. residents who are BIPOC compared to those who are white. Using data from the 2016-2019 Pregnancy Risk Assessment Monitoring System ( = 150,273), we describe health insurance coverage categorized as Medicaid, commercial, or uninsured at the time of childbirth and postpartum. We measured continuity of insurance coverage across these periods, . Analyses were conducted among white and BIPOC residents from rural and urban U.S. counties. Three-quarters (75.3%) of rural white people and 85.3% of urban white people were continuously insured from childbirth to postpartum, compared to 60.5% of rural BIPOC people and 65.6% of urban BIPOC people. Postpartum insurance disruptions were frequent among people with Medicaid coverage at childbirth, particularly among BIPOC individuals, compared to those with private insurance; 17.0% of rural BIPOC residents had Medicaid at birth and became uninsured postpartum Health insurance coverage at childbirth, postpartum, and across these timepoints varies by race/ethnicity and rural compared with urban residents. Policy efforts to extend postpartum Medicaid coverage may reduce inequities at the
一半的孕产妇死亡发生在产后一年内，数据表明黑人、原住民和有色人种（BIPOC）以及农村居民的风险更高。分娩后获得保险可以改善产后健康相关结果，最近的政策努力集中在将产后医疗补助覆盖范围从 60 天延长到产后 1 年。本研究的目的是描述与白人相比，美国农村和城市的 BIPOC 人群的产后医疗保险覆盖情况。使用 2016-2019 年妊娠风险评估监测系统（ = 150,273）的数据，我们描述了分娩时和产后医疗保险覆盖情况，分为医疗补助、商业保险或无保险。我们衡量了这些时期保险覆盖的连续性。分析在来自农村和城市的美国县的白人和 BIPOC 居民中进行。四分之三（75.3%）的农村白人居民和 85.3%的城市白人居民从分娩到产后持续投保，而农村 BIPOC 居民的这一比例为 60.5%，城市 BIPOC 居民为 65.6%。与私人保险相比，分娩时拥有医疗补助的人，尤其是 BIPOC 个人，产后保险中断的情况更为频繁；17.0%的农村 BIPOC 居民在分娩时拥有医疗补助，产后失去了保险。分娩时、产后以及这些时间点的医疗保险覆盖情况因种族/族裔和农村与城市居民而异。延长产后医疗补助覆盖范围的政策努力可能会减少不平等现象。
