North Carolina did not expand Medicaid eligibility under the Affordable Care Act, which continued to put many low-income women at risk for losing health care coverage post partum. The state did comply with ACA standards for simplifying Medicaid enrollment, automating the process and removing a stringent and often cumbersome financial assessment process. Analysis from researchers at Duke University found that these reforms enabled more low-income women to qualify for full Medicaid and reduced the number of women who instead qualified for more limited benefits under the state's Medicaid for Pregnant Women program. Researchers examined Medicaid claims and vital statistics in North Carolina from 2011 to 2017 and determined that, after changing the full Medicaid enrollment process in 2013 to adhere to the ACA standards, enrollment in full Medicaid during pregnancy doubled and Medicaid for Pregnant Women fell. Full Medicaid does not expire after 60 days and allows women access to crucial preventative health services that include primary care and contraception.
Pregnancy Medicaid Improvements in a Nonexpansion State After the Affordable Care Act
Jonas J. Swartz, MD, MPH, et al
Duke University, Department of Obstetrics and Gynecology, Durham, North Carolina