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Urban Evidence Inspires State Leaders to Shift Health Coverage Policy

The Changemakers

State government and District of Columbia leaders

The Challenge

About 1 in 10 new mothers in the US lack access to affordable health insurance—and therefore, critical health care—after giving birth. This is in part because public health insurance for women postdelivery, which is when many poor health outcomes occur, has been limited: eligibility for pregnancy-related Medicaid/Children’s Health Insurance Program (CHIP) coverage ends two months after a woman gives birth.

The Work

Groundbreaking Urban research in 2021 found that 55 percent of uninsured new mothers would become newly eligible for Medicaid if pregnancy-related coverage was extended to one year after giving birth in every state. The proposed change would affect more than 100,000 mothers.

The Impact

Urban’s estimates helped build the foundation for change: The Medicaid and CHIP Payment and Access Commission, a nonpartisan legislative branch agency, included Urban data in a 2021 report to Congress [PDF] recommending a mandatory 12-month postpartum extension. Later that year, Congress gave states the option to extend postpartum Medicaid/CHIP eligibility, which took effect in 2022.

As of November 2023, 37 states and the District of Columbia had extended postpartum Medicaid/CHIP eligibility to a full year—an important policy shift that was informed by Urban’s research.