In 2021, Georgia became one of the first states in the nation to extend postpartum Medicaid coverage. As of late 2022, eligible individuals are entitled to 12 months of continuous coverage with comprehensive benefits after the end of pregnancy.

This study presents findings from interviews with key stakeholders and postpartum Medicaid members in Georgia to assess the early implementation of the Medicaid 12-month postpartum coverage extension and identify challenges and opportunities associated with improving access to care in the full postpartum year and lowering maternal health risks.

Why This Matters

Georgia has some of the worst maternal health outcomes in the nation, and the vast majority of maternal deaths occur within one year after pregnancy. The Medicaid postpartum coverage extension has the potential to improve access to and continuity of care from pregnancy through 12 months after the pregnancy ends. Prior research has found that implementing a postpartum extension is a first step to better supporting new mothers in the critical months after delivery; however, additional policy changes and delivery system improvements may be needed to ensure substantial improvements in maternal health outcomes.

Key Takeaways and Recommendations

• Reports of inappropriate disenrollment and claim denials among postpartum enrollees suggest that administrative systems and processes may not be functioning smoothly. System checks and close monitoring of enrollment changes and claims processing are some steps the Medicaid agency and health plans could take to ensure that all eligible enrollees are covered and able to access services.
• It is unclear how knowledgeable Georgia Medicaid members and health care providers are about the extension. Expanded outreach and education of postpartum enrollees and their health care providers may be necessary to ensure they are aware of and use available services and benefits.
• Improving postpartum visit rates remains a priority, but the Medicaid agency and care management organizations could expand the focus to the full postpartum year to support new mothers in accessing comprehensive health care services beyond well-woman visits, including behavioral, dental, and specialty services.
• Finally, addressing broader maternity care challenges, such as health care workforce shortages and silos between systems serving families, would strengthen postpartum care and promote maternal and infant health.

How We Did It

We conducted semistructured interviews with 20 key stakeholders in Georgia, including state Medicaid and public health department staff, representatives of care management organizations, health care providers, consumer advocates, and staff from community-based organizations serving pregnant and postpartum women. We also conducted telephone interviews with eight postpartum women enrolled in Georgia’s Medicaid program during pregnancy and within 12 months of their most recent birth about their experience with Medicaid benefits and health care during and after pregnancy.