“Our findings indicate that expanding Medicaid coverage led to improved postpartum health for low-income birthing people.”
— Maria W. Steenland, Brown University, and Laura R. Wherry, New York University
Medicaid Expansion Led to Reductions in Postpartum Hospitalizations
Journal Article Jan-01-2023 , and 2-min read
Table of Contents
Table of Contents
Report Publish Date: January 1, 2023
This journal article examines whether Medicaid expansion prevented hospitalizations from postpartum complications.
Primary Takeaways
The authors found that in states that had expanded Medicaid, hospitalizations were 17% lower in the first 60 days after birth than in states that had not expanded Medicaid.
Overview and Objectives
Many women who have insurance through Medicaid during pregnancy go without insurance during the months after they give birth, a time when medical care is extremely important. Medicaid expansion has enabled more people to qualify for coverage before and after pregnancy and to have continuous coverage from pregnancy through birth and into the postpartum period. The authors wanted to know if rates of hospitalization in the weeks and months after birth were lower in states that expanded Medicaid.
Hypothesis or Approach
The authors used 2010-2017 data from the Agency for Healthcare Research and Quality’s Healthcare Cost and Utilization Project State Inpatient Databases. They compared rates of postpartum hospitalization in four expansion and four non-expansion states. They compared rates of hospitalization before and after expansion. They also looked at hospitalization in the first sixty days after birth, during which patients are covered by traditional Medicaid, and after sixty days, during which patients are covered by expanded Medicaid.
How This Influences Change
“Our findings suggest that ongoing efforts to expand Medicaid may contribute to better postpartum health for U.S. birthing people,” the authors write.
Grant Details
Amount awarded:
$43,202
Awarded on: 02/10/2021
Timeframe: 2021-2022
Grant number: 78417
Location: New York, NY
About Grantee:
Research: Go Deeper
The Affordable Care Act (ACA) Medicaid expansions increased preconception and postpartum insurance coverage among low-income birthing people, leading to greater use of outpatient care. In this study we evaluated whether the expansions affected rates of postpartum hospitalization. Our analyses took advantage of underused longitudinal hospital data from the period 2010–17 to examine hospitalizations after childbirth. We compared changes in hospitalizations among birthing people with a Medicaid-financed delivery in states that did and did not expand Medicaid under the ACA. We found a 17 percent reduction in hospitalizations during the first sixty days postpartum associated with the Medicaid expansions and some evidence of a smaller decrease in hospitalizations between sixty-one days and six months postpartum. Our findings indicate that expanding Medicaid coverage led to improved postpartum health for low-income birthing people.
HEALTH AFFAIRS 42, NO. 1 (2023): 18–25. doi: 10.1377/hlthaff.2022.00819
Exhibit 1: Primary diagnoses for postpartum hospitalizations among patients in 8 states with Medicaid-financed deliveries, by timing of hospitalization, 2010–13, page 21.
Research Team
This study and report was conducted and created by the following people.
- Maria W. Steenland
- Laura R. Wherry
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