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Navigating the Labyrinth of Pregnancy-Related Coverage for Undocumented Immigrants: An Assessment of Current State
Amanda DiMeo1, Rasheca Logendran1, Benjamin D Sommers1
1Amanda DiMeo is with Ariadne Labs at Brigham and Women's Hospital and Harvard T. H. Chan School of Public Health, Boston, MA. Rasheca Logendran is with Harvard Medical School, Boston. Benjamin D. Sommers is with Harvard Medical School and Harvard T. H. Chan School of Public Health. Alexandra Beecroft and Yessamin Pazos Herencia are with Brigham Young University, Provo, UT. Maria Bazan, Jeffrey Sprankle, and Rose L. Molina are with the Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston. Carrie Wade is with Countway Library, Harvard Medical School. Margaret M. Sullivan is with François-Xavier Bagnoud Center for Health and Human Rights, Harvard University, Boston.
Abstract:
Insurance coverage for prenatal care, labor and delivery care, and postpartum care for undocumented immigrants consists of a patchwork of state and federal policies, which varies widely by state. According to federal law, states must provide coverage for labor and delivery through Emergency Medicaid. Various states have additional prenatal and postpartum coverage for undocumented immigrants through policy mechanisms such as the Children's Health Insurance Program's "unborn child" option, expansion of Medicaid, and independent state-level mechanisms. Using a search of state Medicaid and federal government websites, we found that 27 states and the District of Columbia provide additional coverage for prenatal care, postpartum care, or both, while 23 states do not. Twelve states include any postpartum coverage; 7 provide coverage for 12 months postpartum. Although information regarding coverage is available publicly online, there exist many barriers to access, such as lack of transparency, lack of availability of information in multiple languages, and incorrect information. More inclusive and easily accessible policies are needed as the first step toward improving maternal health among undocumented immigrants, a population trapped in a complicated web of immigration policy and a maternal health crisis. (Am J Public Health. 2024;114(10):1051-1060. https://doi.org/10.2105/AJPH.2024.307750).
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