New York's Basic Health Program Increased Subsidized Insurance Coverage From Preconception To The Postpartum Period

Area of Science:

• Public Health
• Health Policy
• Maternal Health

Background:

• Access to preconception care and continuous insurance are vital for maternal health.
• The Affordable Care Act's Basic Health Program (BHP) offers affordable insurance for low-income individuals above Medicaid thresholds.
• Understanding the impact of state-level BHP implementation on insurance coverage is crucial.

Purpose of the Study:

• To evaluate the impact of New York's Basic Health Program (BHP) on insurance coverage.
• To assess changes in preconception and continuous postpartum publicly subsidized coverage.

Main Methods:

• Utilized data from the Pregnancy Risk Assessment Monitoring System (2015-20).
• Employed a difference-in-differences design comparing New York's BHP to states without a BHP.
• Examined two primary insurance outcomes: preconception coverage and continuous pre- to postpartum coverage.

Main Results:

• New York's BHP increased preconception BHP and Marketplace coverage by 8.8 percentage points.
• Continuous publicly subsidized coverage from preconception to postpartum increased by 6.9 percentage points.
• The BHP did not significantly alter preconception uninsurance rates.

Conclusions:

• The Basic Health Program (BHP) is a key state policy for improving insurance affordability and stability for pregnant individuals.
• BHP can enhance maternal health by ensuring continuous coverage from preconception through the postpartum period.
• This policy is particularly relevant given current uncertainties in federal Medicaid and Marketplace funding.