State Public Insurance Coverage Policies and Postpartum Care Among Immigrants.

Area of Science:

• Public health
• Health services research
• Health policy

Background:

• Routine postpartum care is recommended for all adults.
• Some states limit public insurance for undocumented and recently documented immigrants.
• These restrictions can create barriers to essential postpartum healthcare.

Purpose of the Study:

• To investigate the link between public insurance coverage and postpartum care receipt among low-income immigrants.
• To compare postpartum care access for immigrants versus nonimmigrants based on state insurance policies.

Main Methods:

• Pooled, cross-sectional analysis of Pregnancy Risk Assessment Monitoring System data (2012-2019).
• Included low-income adults with a live birth across 19 states and New York City.
• Examined postpartum care receipt based on state insurance coverage categories for immigrants (full, moderate, no coverage).

Main Results:

• Immigrants in states with moderate or no public insurance coverage for postpartum care received it less often compared to those in full coverage states.
• States with insurance restrictions showed a greater disparity in postpartum care receipt between immigrants and nonimmigrants.
• Specifically, immigrants had 7.0 to 11.3 percentage points lower postpartum care receipt in moderate/no coverage states versus full coverage states.

Conclusions:

• Public insurance restrictions are associated with reduced postpartum care access for immigrants.
• Policy-driven barriers, such as insurance limitations, negatively affect maternal health among immigrant populations.
• Expanding public insurance coverage for postpartum care could improve health equity for immigrants.