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Medicaid plays a critical role during the perinatal period, but pregnancy-related abstract Medicaid eligibility only extends for 60 days after birth. In 2014, the Affordable Care Act’s (ACA’s) Medicaid expansions increased adult Medicaid eligibility to 138 percent of the federal poverty level in participating states, allowing eligible new mothers to remain covered after pregnancy-related coverage expires. We investigate the impact of ACA Medicaid expansions on insurance coverage among new mothers ages 19 to 44 with incomes below the federal poverty level who report giving birth in the past 12 months. We use 2010–2017 American Community Survey data and a difference-in-differences approach using parental Medicaid-eligibility thresholds to estimate the effect of ACA Medicaid expansions on insurance coverage among poor new mothers.

A 100-percentage-point increase in parental Medicaid-eligibility is associated with an 8.8-percentage-point decrease in uninsurance, a 13.2-percentage-point increase in Medicaid coverage, and a 4.4-percentage-point decrease in private or other coverage among poor new mothers. The average increase in Medicaid eligibility is associated with a 28 percent decrease in uninsurance, a 13 percent increase in Medicaid coverage, and an 18 percent decline in private or other insurance among poor new mothers in expansion states. However, in 2017, around 142,000 new mothers living in poverty remained uninsured.