Postpartum Insurance Churn a Problem in Texas, Study Finds

WASHINGTON, DC (March 21, 2022)—Uninsurance after postpartum Medicaid insurance coverage expires—a phenomenon known as insurance churn—can leave women with limited access to care at a time when they need it. In a study selected as the Editor's Choice for the March/April issue of Women's Health Issues, authors followed postpartum Texans with pregnancies covered by public insurance for a year after birth and found that many lost insurance coverage and encountered difficulties in obtaining care for a range of health conditions.
 
Women’s Health Issues is the official journal of the Jacobs Institute of Women’s Health, which is based in the Department of Health Policy and Management at Milken Institute School of Public Health (Milken Institute SPH) at the George Washington University.
 
Elizabeth J. Ela and colleagues at the University of Texas at Austin used data from the Texas Postpartum Contraception Study—which recruited women who gave birth with coverage from Medicaid or the Children’s Health Insurance Program (CHIP) at one of eight participating Texas hospitals between 2014 and 2016—to examine responses to surveys administered three, six, and 12 months after childbirth. They found that 77% of participants were uninsured at three months postpartum, and most had not acquired coverage by the end of the year.
 
Participants’ responses to open-ended survey questions indicated a variety of health concerns in the postpartum period and barriers to care, the authors reported. Conditions described by uninsured women included gallstones, unexplained vomiting and headaches, and symptoms of anxiety and depression. “If an end result of insurance churn is that women with lower incomes living with chronic conditions only have access to treatment when pregnant, postpartum women may experience severe (and preventable) complications,” Ela and co-authors wrote.
 
“This study makes an important contribution by not only documenting postpartum insurance loss, but reporting on the kinds of health needs that such insurance loss can make it harder to address,” said Amita Vyas, Editor-in-Chief of Women's Health Issues and associate professor of prevention and community health at Milken Institute SPH. “Lawmakers should consider these findings when considering whether to expand Medicaid or extend postpartum Medicaid.”
 
“Insurance Churn and Postpartum Health among Texas Women with Births Covered by Medicaid/CHIP” has been published in the March/April 2022 issue of Women’s Health Issues.