By Joan Alker and Olivia Golden

Today, CLASP and the Georgetown University Center for Children and Families (CCF) are releasing a new report on the important but often-overlooked link between adult health care coverage and children’s healthy development – specifically, the connection between health care coverage and identifying and treating maternal depression, so that children can thrive. Because of the powerful connection between mothers’ mental health and children’s wellbeing and long-term success, Medicaid expansion is a critical tool to help children and should be front and center for child-focused advocates and policymakers.

We are especially excited about this report because of the complementary expertise of our two organizations – CCF on health and CLASP on early childhood care and development. Thank you to our co-authors Stephanie Schmit and Alisa Chester for their hard work synthesizing the research about child development, Medicaid expansion, and maternal depression. The report, Medicaid Expansion Promotes Children’s Development and Family Success by Treating Maternal Depression, distills the research to support four key conclusions.

• Untreated maternal depression is a major public health problem that affects large numbers of women, especially low-income women and their children. More than half (55 percent) of poor infants have a mother who is experiencing some level of depressive symptoms. Maternal depression has been shown to undercut children’s healthy development and stymie families’ efforts to escape poverty. Maternal depression can affect children’s cognitive, socio-emotional, and behavioral development, as well as academic achievement and employment opportunities throughout their lifetime.

• While safe and effective treatments exist, low-income and uninsured women are far less likely to get treatment. More than one-third (37 percent) of low-income mothers with young children who have had a major depressive disorder do not receive any treatment. The cost of mental health care is a major barrier to care, particularly for uninsured mothers.

• States that used the Affordable Care Act (ACA) to expand Medicaid coverage for low-income parents have new opportunities to ensure that women are enrolled and receiving coverage. In the 19 states that have not expanded Medicaid, half a million mothers fall into a coverage gap. They earn too much to qualify for Medicaid coverage but earn too little to qualify for premium assistance through the ACA’s health insurance marketplace. The Medicaid income eligibility threshold for parents in most non-expansion states is extremely low. (See chart).

• Mothers without health insurance face significant financial barriers to getting the care they need to treat maternal depression. As research cited in the report demonstrates, expanding Medicaid coverage to more low-income adults (including mothers) would remove those barriers and help increase access to screening, identification, and treatment of maternal depression—thereby promoting young children’s healthy development and families’ economic security. Access to Medicaid has been shown to reduce the incidence of depression by increasing access to mental health services and diminishing financial barriers to care. For example, new research indicates that Medicaid expansion has not only resulted in improved access to medical benefits but has also resulted in improved access to behavioral health treatment for newly eligible enrollees.

The report concludes that Medicaid expansion for low-income mothers can greatly improve women’s access to treatment for depression, which is vital to children’s healthy development.

Extending Medicaid coverage to more low-income mothers would help increase screening, identification, and treatment of maternal depression—thereby promoting young children’s healthy development and family economic security.

If more states were to accept Medicaid expansion funding, more mothers would gain access to maternal depression screening and treatment and more children would have improved opportunities to reach their full potential.