# Loss of Pregnancy–Related Medicaid Coverage Is Associated With Unmet Need for Health Care, Medical Financial Hardship, and Lower Health Care Use in Postpartum Women

## TL;DR

Losing Medicaid coverage after pregnancy leads to worse health care access and financial strain for postpartum women.

## Contribution

This study shows that losing pregnancy-related Medicaid coverage increases unmet health care needs and financial hardship in postpartum women.

## Key findings

- Uninsured postpartum women who lost Medicaid coverage had higher odds of delaying medical care due to cost.
- They also faced greater unmet needs for medical care, mental health care, and prescriptions.
- These women experienced more medical financial hardship and lower health care use compared to those with continued Medicaid coverage.

## Abstract

We examined the association of loss of pregnancy–related Medicaid coverage with unmet health care needs, medical financial hardship, and health care use in postpartum women participating in a nationally representative household survey.

Cross‐sectional study design.

Using 2012–2018 National Health Interview Survey data, we classified postpartum women as either (1) having Medicaid coverage or (2) uninsured due to loss of pregnancy–related Medicaid coverage. We examined the relationship of loss of pregnancy–related Medicaid coverage with unmet health care needs, medical financial hardship, and health care use.

Compared to Medicaid‐insured postpartum women, uninsured women who lost pregnancy‐related Medicaid coverage had significantly greater odds of delaying medical care due to cost, as well as greater odds of unmet need for medical care, mental health care, and prescriptions. Uninsured postpartum women who lost pregnancy‐related Medicaid coverage also had significantly greater odds of medical financial hardship and lower odds of health care use.

Findings suggest that continued Medicaid coverage during postpartum could improve health care access among uninsured women experiencing loss of pregnancy–related Medicaid eligibility. These results hold important implications for the public health impact of recent policy efforts to extend Medicaid eligibility into the postpartum period.

In this study, uninsurance due to loss of pregnancy–related Medicaid coverage was significantly associated with greater odds of delaying medical care due to cost, unmet need for health care, and medical financial hardship. Sustaining pregnancy‐related Medicaid coverage could improve the health care access of uninsured postpartum women.