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States push to extend postpartum Medicaid benefits to save lives

Michael Ollove, on

Published in News & Features

Many OB-GYNs also say postpartum depression often doesn’t emerge until weeks after delivery.

Yet many women who receive health benefits through Medicaid during pregnancy lack coverage both before pregnancy and for most of the first year after delivery.

“What I see constantly in the communities I care for is a normal process,” said Ebony Marcelle, director of midwifery at Community of Hope, a community health center in Washington, D.C. “You get the 60 days, and you’re dropped.”

A new report in the journal Health Affairs in April found that more than one-third of women who were covered by Medicaid during their pregnancies were without coverage either before conception or within two to six months after pregnancy.

That accounts for a lot of women. More than four out of every 10 births in the United States are paid for by Medicaid, and the rate is even higher among women of color and residents of rural areas, according to Medicaid and CHIP Payment and Access Commission, a nonpartisan legislative branch agency that serves Congress.


“We’re basically saying we only value your health when you’re pregnant,” said Collier.

Untreated chronic conditions such as diabetes and hypertension can lead to more complications during pregnancy and contribute to preterm births and low birth weights, said Dr. Elizabeth Howell, chair of the obstetrics and gynecology department at the University of Pennsylvania Perelman School of Medicine. Those same conditions remain dangerous for women after delivery as well, she said, beyond the time when Medicaid coverage runs out.

“These are women with significant issues — diabetes, high blood pressure — that put them at significant risk,” Howell said. “We end up seeing late deaths of women who were lost to care instead of connected to the care” that might have saved them.

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