My first thread-wish me luck! More on why Medicaid expansion is important for maternal #healthequty

Medicaid covers 25-50% of births in the US and is the largest single-payer of maternity care; Medicaid disproportionately covers low-income women & racial/ethnic minorities. Regarding Medicaid and maternal health, there are two separate/equally important issues.

#1 Expansion of eligibility criteria,"Medicaid expansion". Medicaid coverage lasts up to 60 days postpartum, in non-expansion states, after this time is up, women must requalify for Medicaid as low-income parents; this is harder to do & results in coverage "churn"/ coverage gaps

Medicaid expansion decreases coverage churn, but beyond that does it matter? Some evidence from Gordon et. al to suggest that medicaid expansion may improve coverage stability and use of Medicaid-financed outpatient care postpartum . …https://www-healthaffairs-org.proxy1.library.jhu.edu/doi/full/10.1377/hlthaff.2019.00547?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed&

But perhaps the most important benefit of Medicaid expansion is demonstrated in study by @eleliason @WHIjournal: Medicaid expansion associated w/ maternal mortality by 7.01 maternal deaths per 100,000 live births (p = .002); Effects concentrated among Black mothers.

But is Medicaid expansion enough? Even in the post ACA era, where many states have expanded Medicaid, women still experience coverage churn ( albeit less than in non-expansion states)
https://www.healthaffairs.org/do/10.1377/hblog20190913.387157/full/
Which brings me to #2 extension of benefit coverage time

Currently, Medicaid coverage stops 60 days postpartum. This is not insignificant, in a "Report of 9 Maternal Mortality review committees", 18% of deaths occurred after 42 days postpartum. This varies widely by state. In 2018 Texas reported 56% of deaths AFTER 60 days postpartum.

So there is some clear potential benefit of increasing access during the 1st year postpartum & several states have been working on this, in a recent report @emilyanneck @Health_Affairs gives an overview of the legislative landscape/including federal bills. https://www.healthaffairs.org/do/10.1377/hblog20200203.639479/full/#:~:text=Several%20federal%20bills%20were%20introduced,coverage%20through%2012%20months%20postpartum.&text=This%20legislation%20would%20create%20a,enrolled%20in%20Medicaid%20or%20CHIP.

As a researcher focused on maternal health equity, I know that Medicaid expansion is just 1 lever & several more need pulling! Excited about the Black Maternal health #Momnibus act by @Repadams @KamalaHarris @LaurenUnderwood. 9 bills to try & address this maternal health crisis.