State Uptake of Medicaid Postpartum Extension Under the American Rescue Plan Act of 2021

The American Rescue Plan Act of 2021 (ARP) gave states an opportunity to permanently expand coverage from 60 days to 12 months postpartum through a State Plan Amendment (SPA) as of April 1, 2022. Building on work that started as part of the ARP National Evaluation, AIR summarized state uptake of the ARP option through an environmental scan and descriptive analyses.

All states seem to have taken action to extend Medicaid postpartum coverage since ARP was implemented, including states that did not adopt the Affordable Care Act Medicaid expansion. However, pending state legislation in some states failed to pass their legislatures prior to the close of this legislative session. It remains to be seen if postpartum coverage legislation will be picked up again when these state legislatures reconvene or if those states with still-pending state action will ultimately implement extended postpartum coverage.

Providing states with options to extend coverage for a specific population and amount of time may be an effective policy lever to improve maternal health outcomes. Future research should follow state actions regarding coverage transitions for postpartum individuals as continuous enrollment ends, as well as the associated impacts on postpartum health.