Patterns of Health Insurance Coverage Around the Time of Pregnancy Among Women with Live-Born Infants — Pregnancy Risk Assessment Monitoring System, 29 States, 2009
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Patterns of Health Insurance Coverage Around the Time of Pregnancy Among Women with Live-Born Infants — Pregnancy Risk Assessment Monitoring System, 29 States, 2009

Filetype[PDF-698.14 KB]


  • English
    • Details Supporting Files You May Also Like

    Details:

    • Alternative Title:
      MMWR Surveill Summ
    • Personal Author:
    • Description:
      Problem/Condition:

      In 2009, before passage of the 2010 Patient Protection and Affordable Care Act (ACA), approximately 20% of women aged 18–64 years had no health insurance coverage. In addition, many women experienced transitions in coverage around the time of pregnancy. Having no health insurance coverage or experiencing gaps or shifts in coverage can be a barrier to receiving preventive health services and treatment for health problems that could affect pregnancy and newborn health. With the passage of ACA, women who were previously uninsured or had insurance that provided inadequate coverage might have better access to health services and better coverage, including additional preventive services with no cost sharing. Because certain elements of ACA (e.g., no lifetime dollar limits, dependent coverage to age 26, and provision of preventive services without cost sharing) were implemented as early as September 2010, data from 2009 can be used as a baseline to measure the incremental impact of ACA on the continuity of health care coverage for women around the time of pregnancy.

      Reporting Period Covered:

      2009.

      Description of System:

      The Pregnancy Risk Assessment Monitoring System (PRAMS) is an ongoing state- and population-based surveillance system designed to monitor selected maternal behaviors and experiences that occur before, during, and shortly after pregnancy among women who deliver live-born infants in selected U.S. states and New York City, New York. PRAMS uses mixed-mode data collection, in which up to three self-administered surveys are mailed to a sample of mothers, and those who do not respond are contacted for telephone interviews. Self-reported survey data are linked to birth certificate data and weighted for sample design, nonresponse, and noncoverage. Annual PRAMS data sets are created and used to produce statewide estimates of preconception and perinatal health behaviors and experiences in selected states and New York City.

      Results:

      In 2009, 30.1% of women who had a live birth experienced changes in health insurance coverage in the period between the month before pregnancy and the time of delivery, either because they lacked coverage at some point or because they moved between different types of coverage. Most women had stable coverage across the three time periods, reporting either private coverage (52.8%) or Medicaid coverage (16.1%) throughout. A small percentage of women (1.1%) reported having no health insurance coverage at any point.

      Interpretation:

      In 2009, nearly one third of women reported lacking health insurance or transitioning between types of health insurance coverage around the time of pregnancy. The majority of women who changed health insurance status obtained coverage for prenatal care, delivery, or both through Medicaid. Health insurance coverage during pregnancy can help facilitate access to health care and allow for the identification and treatment of health-related issues; however, prenatal coverage might be too late to prevent the consequences of preexisting conditions and preconception exposures that could affect maternal and infant health. Continuous access to health insurance and health care for women of reproductive age could improve maternal and infant health by providing the opportunity to manage or treat conditions that are present before and between pregnancies.

      Public Health Action:

      PRAMS data can be used to identify patterns of health insurance coverage among women around the time of pregnancy. Removing barriers to obtaining health insurance for women who lack coverage, particularly before pregnancy, could improve the health of women and their infants. The findings in this report can be used by public health professionals, policy analysts, and others to monitor health insurance coverage for women around the time of pregnancy. In particular, 2009 state-specific data can serve as baseline information to assess and monitor changes in health insurance coverage since the passage of ACA.

    • Subjects:
    • Source:
      MMWR Surveill Summ. 64(4):1-19
    • Pubmed ID:
      26086743
    • Pubmed Central ID:
      PMC10966621
    • Document Type:
      Journal Article
    • Funding:
      CC999999/ImCDC/Intramural CDC HHSUnited States/
    • Collection(s):
    • Main Document Checksum:
    • Download URL:
    • File Type:

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