Medicaid redetermination: what it means for maternal health

min read

We believe that access to high-quality healthcare is a human right, particularly for pregnant people. Over the last six decades, Medicaid has been an instrumental program in closing the healthcare access gap for low-income patients. Since the beginning of the COVID-19 pandemic, national Medicaid enrollment has increased significantly. This increase was largely due to continuous enrollment, a policy in which states were barred from disenrolling people from coverage. But as of April 1, 2023, as this policy sunsets, anywhere from 8 to 24 million people could be left without coverage due to loss of their Medicaid eligibility. As a business that is proud to serve Medicaid members, we believe that Medicaid should be expanded to cover as many uncovered Americans as possible to facilitate healthcare access.

In Texas, where there are strict rules established by the state for patients to qualify for Medicaid resulting in high rates of uninsurance and underinsurance, over 500K people lost coverage between April and July. As of April 2023, Texas had nearly 6 million Medicaid members, now down below 5.5 million. States with broader Medicaid coverage like California have fared significantly better with the post-pandemic redetermination. Though California has also lost 300K members since April, California’s total Medicaid population far outnumbers Texas’s: 15.5 million Californians remain enrolled in August 2023, compared to 15.8 million in April 2023.

Studies on the recent effects of Medicaid expansion on adverse pregnancy outcomes show mixed results. Several studies positively associated expansion with improved maternal and infant outcomes at childbirth. Medicaid finances 4 in 10 births in the U.S., and a higher proportion for people of color: Medicaid covers more than half of births to Black, Hispanic, and Native patients. Pre-pandemic state Medicaid expansion was associated with reduced racial disparities in low birth weight and preterm birth. For the most vulnerable patients, Medicaid coverage provides a crucial safety net during pregnancy and postpartum.

Most states have already extended Medicaid to cover eligible pregnant patients up to 12 months postpartum, ensuring that patients have access to care during a crucial period: over half of pregnancy-related deaths happen up to a year after delivery. Postpartum complications like postpartum depression (PPD), cardiac conditions, and postpartum hypertension mean a patient needs continuous access to an interdisciplinary care team including mental health providers.

With Delfina Care, patients have access to a customized, data-driven pregnancy care solution that aims to take the uncertainty out of pregnancy. We are proud to serve Medicaid populations, with our platform that is specifically designed to improve their maternal and child health outcomes at lower overall cost. Our Medicaid plan partners are also finding that offering Delfina Care associates with higher member enrollment and retention, presenting a rare growth opportunity in the setting of the ongoing redetermination.

Patients deserve access to holistic and supportive that meets their needs, whether it’s during pregnancy or postpartum. Delfina is committed to creating a safe, supported journey for every pregnancy - especially for low-income mothers who are too often left behind. If you represent a Medicaid plan and want to explore how Delfina can lower your same-year costs and expand your enrollment, we would love to hear from you

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