Postpartum Medicaid Coverage and Behavioral Health Treatment Among Pregnant Women with Substance Use Disorder

Prenatal substance use is a significant risk factor for adverse pregnancy and birth outcomes. Postpartum health coverage is critical in addressing health care need among pregnant women with substance use disorder (SUD), as a significant portion of maternal mortality occurs during the postpartum period. Under current law, coverage for those enrolled in Medicaid through the pregnancy pathway ends after 60 days postpartum, unless they are eligible through another pathway. The 2021 American Rescue Plan (ARP) and the 2022 Consolidated Appropriations Act (CAA) provides an option for states to extend postpartum coverage in Medicaid up to 12 months after birth. Given impending state decisions on postpartum coverage extension, we sought to estimate behavioral health service use among pregnant women with SUD in Medicaid who lost coverage after 60 days compared to those that did not lose coverage.