Medicaid Coverage of Pregnancy-Related Services: Findings from a 2021 State Survey

This survey was conducted at a time of greater national attention to the state of maternal health, an area where Medicaid has long played a major role. On the whole, this survey finds that states offer broad coverage for basic pregnancy-related services, but that some impose utilization controls. Coverage for services outside of the medical setting is mixed, with most states covering home visits but limited coverage for educational classes and home-base lactation consultations. Very few states offer any coverage for fertility assistance services.

Most states also reported that they are working on ways to strengthen Medicaid coverage of maternity services. In particular, some states have already extended the postpartum coverage period to one year, while several others are considering this option. Several states have also expressed interest in covering doula benefits and better integration of substance use treatment services for pregnant and postpartum people. Many of these issues have also been raised by clinical groups as priority areas for improving maternal health.

Acknowledgements

The authors thank the numerous staff members in state Medicaid agencies who participated in the survey. The authors also thank the following individuals, who provided input in the survey questionnaire, data management, and analysis: Jim McEvoy and Kraig Gazley of Health Management Associates; Nan Strauss, Yuki Davis, and Jenny Chang of Every Mother Counts; Michelle Moniz of University of Michigan Institute of Healthcare Policy and Innovation; Mara D’Amico of ACOG.