The Association Between Continuity Of Marketplace Coverage During Pregnancy And Receipt Of Prenatal Care

Insurance disruptions before, during, and after pregnancy are common in the United States, but little is known about the enrollment patterns of pregnant people in the Affordable Care Act Marketplaces. Data from the Pregnancy Risk Assessment Monitoring System from the period 2016-18 show that among r...

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Bibliographic Details
Published in:Health affairs (Millwood, Va.) Va.), 2021-10, Vol.40 (10), p.1618-15
Main Authors: Gordon, Sarah H, Alger, Charlotte L, Declercq, Eugene R, Garrido, Melissa M
Format: Article
Language:English
Subjects:
Births
Continuity
Demographics
Enrollments
Health insurance
Insurance
Insurance coverage
Monitoring systems
Patient Protection & Affordable Care Act 2010-US
Postpartum
Postpartum period
Pregnancy
Prenatal care
Respondents
Risk assessment
Surveillance
Variables
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Summary:Insurance disruptions before, during, and after pregnancy are common in the United States, but little is known about the enrollment patterns of pregnant people in the Affordable Care Act Marketplaces. Data from the Pregnancy Risk Assessment Monitoring System from the period 2016-18 show that among respondents enrolled in Marketplace coverage, approximately one-third reported continuous Marketplace enrollment from preconception through the postpartum period. Compared with respondents who were continuously enrolled in Marketplace coverage from preconception through postpartum, respondents who enrolled in Marketplace plans during pregnancy had a 10.8 percent lower rate of adequate prenatal care, a 6.4 percent lower rate of timely prenatal care initiation, and a 13.2 percent lower rate of having twelve or more prenatal care visits. Policies that promote continuity of coverage during pregnancy, such as designating pregnancy as a qualifying event for a Marketplace open enrollment period, may enable pregnant people to enroll in Marketplace coverage early in their pregnancies and thus enhance access to prenatal care.
ISSN:0278-2715
1544-5208
DOI:10.1377/hlthaff.2021.00581