ACA Medicaid Expansions Reduced Numbers of Uninsured Mothers, but Thousands Still Lacked Coverage in 2017: Study

​Approximately 451,000 new mothers were uninsured in 2017, about 142,000 of whom were U.S. citizens living in poverty -- despite the expansion of Medicaid in some states, according to a study published in the May 2020 Pediatrics. The study, “ACA Medicaid Expansion and Insurance Coverage Among New Mothers Living in Poverty” (published online April 15) highlighted the gains made with the Affordable Care Act in reducing uninsurance among new mothers living in poverty. The average increase in Medicaid eligibility was associated with a 28% decrease in uninsurance, a 13% increase in Medicaid coverage, and an 18% decline in private/other insurance among poor new mothers in expansion states. Despite those gains, the study found that more women could gain coverage if their state implemented ACA Medicaid expansion, extended pregnancy-related Medicaid eligibility postpartum, or increased take-up and retention among those already eligible for Medicaid. The authors suggest that state or federal policies extending pregnancy-related Medicaid coverage from 60 days to one year postpartum would benefit many mothers during a period when families have critical health care needs. New mothers living in poverty need insurance coverage to help them access and afford necessary physical and mental health care, reduce stress and financial hardship, and improve the health and well-being of their entire family. 

Editor’s note: A solicited commentary, “Family Values Means Covering Families: Parents Need to Focus on Parenting, Not Access to Care,” will be published in the same issue of Pediatrics.

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.