Medicaid Eligibility Category Among Enrollees With Medicaid-Paid Births in 2018.

OBJECTIVE

To identify the Medicaid eligibility category at delivery and 6 months prior among those with Medicaid and Children's Health Insurance Program (CHIP)-financed births.

STUDY SETTING AND

DESIGN

Descriptive analysis of 2018 national Medicaid claims data.

DATA SOURCES AND ANALYTIC SAMPLE: We used the 2018 Transformed Medicaid Statistical Information System Analytic Files to assess Medicaid/CHIP eligibility category at the time of birth and 6 months prior during pregnancy among enrollees with Medicaid/CHIP-paid births in 2018, stratifying by age, race/ethnicity, and state.

PRINCIPAL FINDINGS: Just over half (56.2%) of those enrolled in Medicaid/CHIP in 2018 were enrolled in the pregnancy eligibility category at delivery, while 29.5% were enrolled as parents, 8.2% as low-income adults, and 6.1% in other categories. The proportion of pregnant women enrolled via the pregnancy eligibility category varied widely by state, from 11.9% in Kentucky to 97.5% in Texas.

CONCLUSIONS

Nearly half of pregnant Medicaid/CHIP enrollees were not enrolled via pregnancy Medicaid eligibility when they delivered. It is important for states to be aware of pregnancy status to apply correct eligibility criteria and benefits for pregnant and postpartum enrollees, including the 12 months of extended postpartum coverage newly available and elected in nearly all states.