Uninsured new mothers face plenty of health challenges. COVID-19 could make that worse

New mothers face significant challenges when they lack health coverage—a concern the industry should be watching as the COVID-19 pandemic continues, researchers say.

Researchers at the Urban Institute, a left-leaning think tank, analyzed responses from between 2015 and 2018 to the National Health Interview Survey and data from 2015 to 2017 from the Pregnancy Risk Assessment and Monitoring System and found 1 in 5 uninsured new mothers reported an unmet health need because of the cost.

The study found 14.2% of uninsured new mothers reported an unmet need for medical care, and 17% reported an unmet need for prescriptions. Plus, 16% said they delayed care in the past 12 months due to cost.

There were also signs that these women struggled to access care broadly. Just over half (55.8%) reported having a consistent source of care, and while 82.2% had visited an OB-GYN in the prior year, just 42% saw a general practitioner.

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In addition, more than half said they were very worried about being able to afford their medical bills.  

About 7.5% of new mothers said they felt depressed after giving birth, while 11.4% said they felt a “lack of interest” in activity. About 20% said they sometimes felt depressed or a lack of interest after giving birth.

Stacey McMorrow, the study’s lead author and principal research associate at Urban Institute, told FierceHealthcare these are concerning statistics as pregnancy and new motherhood is already a highly stressful time, so compounding that can have negative effects.

“The mental health challenges are particularly troubling as they can have real spillover effects,” McMorrow said.

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Rising maternal mortality rates is a hot-button healthcare topic, but the data are especially relevant in light of the COVID-19 pandemic, the researchers said, as job losses—and thus insurance coverage losses—continue to rise.

A previous analysis from the Urban Institute estimated that a 20% unemployment rate could lead to as many as 43 million people losing their insurance coverage.

“These findings are particularly relevant given the COVID-19 pandemic and ensuing economic crisis, which will put even more women at risk of uninsurance and in need of affordable coverage options before, during, and after pregnancy,” the research team wrote.

McMorrow said there is a bright spot, however, as legislation targeting the pandemic has barred states from booting people out of Medicaid if they accepted additional federal funding. So a woman who enrolled in Medicaid for pregnancy coverage may be able to stay enrolled beyond the typical 60-day postpartum window.

On the other hand, a new mother who is now uninsured due to a job loss related to the pandemic will have to meet more stringent eligibility rules to enroll in non-pregnancy-related Medicaid benefits, McMorrow said.