Association of Medicaid vs Marketplace Eligibility on Maternal Coverage and Access With Prenatal and Postpartum Care

Key Points Question How does preconception and postpartum coverage and care use compare among women with low incomes gaining eligibility for Medicaid vs marketplace coverage? Findings In this cohort study of 11 432 women with low incomes, Medicaid eligibility relative to marketplace eligibility was associated with significantly increased Medicaid coverage (20.3 percentage points), decreased private insurance coverage (−10.8 percentage points), and decreased uninsurance (−8.7 percentage points) in the preconception period. It was also associated with increased postpartum Medicaid (17.4 percentage points) and increased adequate prenatal care (4.4 percentage points) but not with significant changes in early prenatal care, postpartum checkups, or postpartum contraception. Meaning The finding of lower rates of preconception uninsurance among Medicaid-eligible women in this study suggests that women with low incomes were facing barriers to marketplace enrollment.

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