Mary Alice Lee, Ph.D. and Sarah Esty
There is growing recognition of the importance of good maternal health before pregnancy, including the time between the birth of one child and the conception of the next. This period offers a window of opportunity for addressing family planning and any outstanding health issues, with the goal of improving maternal health for subsequent pregnancies. Access to care is critically important during this period.
This study investigated the continuity of health insurance coverage in the prenatal and postpartum periods for women who gave birth while enrolled in HUSKY A (Medicaid managed care) in 2009.
- Prior to the birth, pregnant women were enrolled in HUSKY A an average of 6 months, with 42 percent continuously enrolled for nine months.
- Following the birth, over 70 percent of new mothers were continuously enrolled for nine months.
- The likelihood of gaps or loss of coverage in the postpartum period was far greater for mothers who qualified for coverage during pregnancy through 60 days postpartum, compared with mothers in ongoing Medicaid family and child coverage groups. At nine months after the birth more than half of all mothers with pregnancy-related coverage had experienced a gap or lost coverage.
- Coverage continuity also varied by where the mother lived, suggesting that community-based application support and administrative procedures in the Medicaid agency’s district offices play a role in facilitating coverage in the postpartum period.
These findings have implications for Medicaid program administration and for design of an integrated eligibility management system that will facilitate seamless automated coverage transitions between Medicaid and other insurance options offered by Connecticut’s Health Insurance Exchange in 2014.
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