Building the Evidence base

Since the early 1990s, Medicaid has been critical in providing insurance coverage for pregnant women with low incomes in the United States - pregnancy-related Medicaid coverage is available to women with incomes up to 200 percent of the federal poverty level in most states. Because pregnancy-related Medicaid eligibility is almost always more generous than eligibility for other adults, many women with low incomes not otherwise eligible for Medicaid gain coverage during their pregnancies but then lose that coverage sixty days after delivery, when their pregnancy-related eligibility expires. The American Rescue Plan Act of 2021 included an option for states to extend Medicaid coverage for twelve months postpartum. While the ACA provided coverage improvements for pregnant women outside of pregnancy, especially in states expanding Medicaid, many low-income women remain uninsured before or after their pregnancies. Building on existing studies tracking changes in Medicaid coverage and uninsurance under the law, researchers Emily M. Johnston, Stacey McMorrow, Clara Alvarez Caraveo and Lisa Dubay examined data for new mothers with Medicaid-covered prenatal care in this study published in Health Affairs.

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The health and well-being of people are intimately tied to the conditions of life in their communities—conditions that structure opportunities and pathways for lifelong and even inter-generational well-being. Philanthropic efforts to improve community health must attend to the many systems that shape life conditions by focusing not only on whom, what, or where to fund, but equally importantly, on how to fund. The Urban Institute’s recent comprehensive review of health-focused community development investments made by the Robert Wood Johnson Foundation between 2013 and 2019 yielded a wide range of insights about how philanthropic investments can drive enduring systems change needed to improve community health, well-being, and equity across the nation.