New Research Links Postpartum Medicaid Coverage to Increased Mental Health Care

A new study in this month’s issue of Health Affairs offers additional insights into the impact of postpartum Medicaid coverage on access to care. In short: continuous postpartum Medicaid coverage increased stability, access, and affordability to outpatient mental health and prescription medication treatments for perinatal mood and anxiety disorders compared with those who transitioned to commercial coverage.

As highlighted in our report on State Medicaid Opportunities to Support Mental Health of Mothers and Babies During the 12-Month Postpartum Period, Congress enacted legislation in 2021 to allow states to extend postpartum coverage from 60 days to 12 months for pregnant individuals in Medicaid and CHIP. The vast majority of states (48) have taken up or are working toward implementing the 12-month postpartum coverage period. This relatively new state option provides a unique chance for states to consider how the health system should be leveraged to ensure mental health, behavioral health, and substance use issues are identified and addressed as soon as possible to ensure postpartum parents, their infants, and the parent-child relationship are set up to thrive in the long term.

Using data from the Colorado All Payer Claims Database, as well as birth records and income data, for 2014-2019, the researchers found that staying enrolled in Medicaid, compared to enrolling in commercial coverage, was associated with a 20.5 percentage-point increase in the rate of outpatient mental health visits or filling at least one prescription for anxiety or depression during the postpartum year. Medicaid coverage was also associated with nearly a 20 percentage-point increase in continuous postpartum mental health treatment (3 or more visits or prescription fills). In addition, among those who received postpartum treatment, out-of-pocket spending was over $40 lower per mental health visit and $3 lower per prescription fill for those who remained enrolled in Medicaid compared to those who transitioned to commercial coverage.

Taken together, the findings suggest that extending Medicaid coverage to 12 months postpartum and allowing individuals to retain their Medicaid coverage instead of enrolling in commercial insurance after birth is associated with fewer and smaller barriers to postpartum mental health care.

For additional concrete steps state Medicaid agencies can take to address mental health among mothers and infants in the postpartum year check out our full January report.

Anne Dwyer is an Associate Research Professor at the Georgetown University McCourt School of Public Policy’s Center for Children and Families.