Changes in postpartum insurance and care use by disability status during the COVID-19 pandemic.
Erica L Eliason, Meghan Bellerose
PMID 38233252WHAT IT FOUND
During the pandemic, postpartum Medicaid coverage rose and uninsurance fell for people with disabilities.
However, this did not lead to more postpartum visits or contraceptive care compared to people without disabilities. Coverage gains alone did not close the gap in care use.
Key findings
01The pandemic was associated with a 7.1 percentage point increase in postpartum Medicaid and a 5.2 percentage point decrease in uninsurance for people with disabilities relative to those without.
02Despite improved insurance coverage, there were no significant differential changes in postpartum check-ups or contraceptive care use for people with disabilities compared to those without disabilities.
03Postpartum visit attendance remained stable for people with disabilities during the pandemic, while it significantly declined for people without disabilities.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study only included 17 states and DC, so results may not reflect the entire US. Researchers could not analyze differences by specific type of disability or race/ethnicity due to sample size limits. All data was self-reported, which introduces potential recall bias. The study period was limited to two years, so it could not check if trends were already moving differently before the pandemic.
Declared interests
The study used data from the CDC's Pregnancy Risk Assessment Monitoring System (PRAMS). The paper does not list specific financial conflicts of interest or commercial sponsors for this analysis.
The easy way to misread this
Do not assume that expanding insurance coverage alone will increase postpartum care attendance for patients with disabilities. The study found that while coverage improved significantly, care use did not increase relative to the non-disabled population, suggesting other barriers remain.