Amanda DiMeo is with Ariadne Labs at Brigham and Women's Hospital and Harvard T. H. Chan School of Public Health, Boston, MA. Rasheca Logendran is with Harvard Medical School, Boston. Benjamin D. Sommers is with Harvard Medical School and Harvard T. H. Chan School of Public Health. Alexandra Beecroft and Yessamin Pazos Herencia are with Brigham Young University, Provo, UT. Maria Bazan, Jeffrey Sprankle, and Rose L. Molina are with the Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston. Carrie Wade is with Countway Library, Harvard Medical School. Margaret M. Sullivan is with François-Xavier Bagnoud Center for Health and Human Rights, Harvard University, Boston.
Am J Public Health. 2024 Oct;114(10):1051-1060. doi: 10.2105/AJPH.2024.307750. Epub 2024 Aug 15.
Insurance coverage for prenatal care, labor and delivery care, and postpartum care for undocumented immigrants consists of a patchwork of state and federal policies, which varies widely by state. According to federal law, states must provide coverage for labor and delivery through Emergency Medicaid. Various states have additional prenatal and postpartum coverage for undocumented immigrants through policy mechanisms such as the Children's Health Insurance Program's "unborn child" option, expansion of Medicaid, and independent state-level mechanisms. Using a search of state Medicaid and federal government websites, we found that 27 states and the District of Columbia provide additional coverage for prenatal care, postpartum care, or both, while 23 states do not. Twelve states include any postpartum coverage; 7 provide coverage for 12 months postpartum. Although information regarding coverage is available publicly online, there exist many barriers to access, such as lack of transparency, lack of availability of information in multiple languages, and incorrect information. More inclusive and easily accessible policies are needed as the first step toward improving maternal health among undocumented immigrants, a population trapped in a complicated web of immigration policy and a maternal health crisis. (. 2024;114(10):1051-1060. https://doi.org/10.2105/AJPH.2024.307750).
对于无证移民的产前护理、分娩护理和产后护理,保险覆盖范围包括州和联邦政策的拼凑,各州的政策差异很大。根据联邦法律,各州必须通过紧急医疗补助计划为分娩提供保险。各州通过各种政策机制为无证移民提供额外的产前和产后保险,例如儿童健康保险计划的“胎儿”选项、扩大医疗补助范围以及独立的州一级机制。通过对州医疗补助和联邦政府网站的搜索,我们发现 27 个州和哥伦比亚特区提供了额外的产前护理、产后护理或两者的覆盖范围,而 23 个州没有。12 个州包括任何产后护理;7 个州提供 12 个月的产后护理。尽管关于覆盖范围的信息可以在网上公开获得,但获得这些信息存在许多障碍,例如缺乏透明度、缺乏多种语言的信息可用性以及信息不正确。需要制定更具包容性和更易于获得的政策,作为改善无证移民产妇健康的第一步,这部分人群陷入了复杂的移民政策和产妇健康危机之中。(. 2024;114(10):1051-1060. https://doi.org/10.2105/AJPH.2024.307750)。