{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T16:36:51Z","timestamp":1772987811274,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T00:00:00Z","timestamp":1762473600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T00:00:00Z","timestamp":1762473600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000016","name":"U.S. Department of Health and Human Services","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000016","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Services Research"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify the Medicaid eligibility category at delivery and 6\u2009months prior among those with Medicaid and Children's Health Insurance Program (CHIP)\u2010financed births.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Setting and Design<\/jats:title>\n                    <jats:p>Descriptive analysis of 2018 national Medicaid claims data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources and Analytic Sample<\/jats:title>\n                    <jats:p>We used the 2018 Transformed Medicaid Statistical Information System Analytic Files to assess Medicaid\/CHIP eligibility category at the time of birth and 6\u2009months prior during pregnancy among enrollees with Medicaid\/CHIP\u2010paid births in 2018, stratifying by age, race\/ethnicity, and state.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Principal Findings<\/jats:title>\n                    <jats:p>Just over half (56.2%) of those enrolled in Medicaid\/CHIP in 2018 were enrolled in the pregnancy eligibility category at delivery, while 29.5% were enrolled as parents, 8.2% as low\u2010income adults, and 6.1% in other categories. The proportion of pregnant women enrolled via the pregnancy eligibility category varied widely by state, from 11.9% in Kentucky to 97.5% in Texas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Nearly half of pregnant Medicaid\/CHIP enrollees were not enrolled via pregnancy Medicaid eligibility when they delivered. It is important for states to be aware of pregnancy status to apply correct eligibility criteria and benefits for pregnant and postpartum enrollees, including the 12\u2009months of extended postpartum coverage newly available and elected in nearly all states.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1475-6773.70053","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T14:34:46Z","timestamp":1762526086000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Medicaid Eligibility Category Among Enrollees With Medicaid\u2010Paid Births in 2018"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4743-2014","authenticated-orcid":false,"given":"Sarah H.","family":"Gordon","sequence":"first","affiliation":[{"name":"Department of Health Law, Policy, and Management Boston University School of Public Health Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amelia","family":"Whitman","sequence":"additional","affiliation":[{"name":"Social Science Analyst"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Buchmueller","sequence":"additional","affiliation":[{"name":"Stephen M. Ross School of Business University of Michigan Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6507-6047","authenticated-orcid":false,"given":"Benjamin D.","family":"Sommers","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management Harvard T. H. Chan School of Public Health Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,7]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"I.Gomez U.Ranji A.Salganicoff andB.Frederiksen \u201cMedicaid Coverage for Women \u201dKaiser Family Foundation February 17 2022 https:\/\/www.kff.org\/womens\u2010health\u2010policy\/issue\u2010brief\/medicaid\u2010coverage\u2010for\u2010women\/."},{"key":"e_1_2_9_3_1","unstructured":"Kaiser Family Foundation \u201cMedicaid Postpartum Coverage Extension Tracker \u201daccessed November 10 2024 https:\/\/www.kff.org\/medicaid\/issue\u2010brief\/medicaid\u2010postpartum\u2010coverage\u2010extension\u2010tracker\/."},{"key":"e_1_2_9_4_1","unstructured":"eCFR \u201c42 CFR 435.116\u2014Pregnant Women \u201daccessed November 11 2024 https:\/\/www.ecfr.gov\/current\/title\u201042\/part\u2010435\/section\u2010435.116."},{"key":"e_1_2_9_5_1","unstructured":"LII (Legal Information Institute) \u201c42 CFR \u00a7 435.170\u2014Pregnant Women Eligible for Extended or Continuous Eligibility \u201daccessed November 11 2024 https:\/\/www.law.cornell.edu\/cfr\/text\/42\/435.170."},{"key":"e_1_2_9_6_1","unstructured":"Centers for Medicare and Medicaid Services (CMS) \u201cImproving Maternal Health and Extending Postpartum Coverage in Medicaid and the Children's Health Insurance Program (CHIP) (SHO# 21\u2010007) \u201dDecember 7 2021 https:\/\/www.medicaid.gov\/federal\u2010policy\u2010guidance\/downloads\/sho21007.pdf."},{"key":"e_1_2_9_7_1","unstructured":"A.Levisohn \u201cState Medicaid Coverage of Dental Services for General Adult and Pregnant Populations \u201dNASHP May 26 2022 https:\/\/nashp.org\/state\u2010tracker\/state\u2010medicaid\u2010coverage\u2010of\u2010dental\u2010services\u2010for\u2010general\u2010adult\u2010and\u2010pregnant\u2010populations\/."},{"key":"e_1_2_9_8_1","unstructured":"eCFR \u201c42 CFR 435.404\u2014Applicant's Choice of Category \u201daccessed November 11 2024 https:\/\/www.ecfr.gov\/current\/title\u201042\/part\u2010435\/section\u2010435.404."},{"key":"e_1_2_9_9_1","unstructured":"Medicaid \u201cReporting PRIMARY\u2010ELIGIBILITY\u2010GROUP\u2010IND (Eligibility) \u201daccessed November 11 2024 https:\/\/www.medicaid.gov\/medicaid\/data\u2010and\u2010systems\/macbis\/tmsis\/tmsis\u2010blog\/entry\/47573."},{"key":"e_1_2_9_10_1","unstructured":"V.ThompsonandA.Hasan \u201cMedicaid Reimbursement for Home Visiting: Findings From a 50\u2010State Analysis \u201dNASHP May 1 2023 https:\/\/nashp.org\/state\u2010medicaid\u2010reimbursement\u2010for\u2010home\u2010visiting\u2010findings\u2010from\u2010a\u201050\u2010state\u2010analysis\/."},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2019.12.005"},{"key":"e_1_2_9_12_1","unstructured":"U.Ranji I.Gomez A.Salganicoff C.Rosenzweig andR.Kellenberg \u201cMedicaid Coverage of Pregnancy\u2010Related Services: Findings From a 2021 State Survey \u201dMay 19 2022 https:\/\/www.kff.org\/report\u2010section\/medicaid\u2010coverage\u2010of\u2010pregnancy\u2010related\u2010services\u2010findings\u2010from\u2010a\u20102021\u2010state\u2010survey\u2010report\/."},{"key":"e_1_2_9_13_1","unstructured":"Centers for Disease Control and Prevention (CDC) \u201cSTATE System Medicaid Coverage of Tobacco Cessation Treatments Fact Sheet \u201d2024 https:\/\/www\u2010cdc\u2010gov\/statesystem\/factsheets\/medicaid\/Cessation.html."},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2016.1241"},{"key":"e_1_2_9_15_1","unstructured":"Kaiser Family Foundation \u201cMedicaid and CHIP Income Eligibility Limits for Pregnant Women 2003\u20132023 \u201daccessed November 11 2024 https:\/\/www.kff.org\/medicaid\/state\u2010indicator\/medicaid\u2010and\u2010chip\u2010income\u2010eligibility\u2010limits\u2010for\u2010pregnant\u2010women\/."},{"key":"e_1_2_9_16_1","unstructured":"Kaiser Family Foundation \u201cMedicaid Income Eligibility Limits for Parents 2002\u20132023 \u201daccessed November 11 2024 https:\/\/www.kff.org\/medicaid\/state\u2010indicator\/medicaid\u2010income\u2010eligibility\u2010limits\u2010for\u2010parents\/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22 %22sort%22:%22asc%22%7D."},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2023.00580"},{"key":"e_1_2_9_18_1","unstructured":"J. R.Daw K. B.Kozhimannil andL. K.Admon \u201cHigh Rates of Perinatal Insurance Churn Persist After the ACA \u201dHealth Affairs Forefront September 16 2019 https:\/\/www.healthaffairs.org\/do\/10.1377\/forefront.20190913.387157\/full\/."},{"key":"e_1_2_9_19_1","unstructured":"T.Brooks S.Miskell S.Artiga et\u00a0al. \u201cMedicaid and CHIP Eligibility Enrollment Renewal and Cost\u2010Sharing Policies as of January 2018: Findings From a 50\u2010State Survey \u201dThe Henry J. Kaiser Family Foundation March 2018 https:\/\/files.kff.org\/attachment\/Report\u2010Medicaid\u2010and\u2010CHIP\u2010Eligibility\u2010Enrollment\u2010Renewal\u2010and\u2010Cost\u2010Sharing\u2010Policies\u2010as\u2010of\u2010January\u20102018."},{"key":"e_1_2_9_20_1","unstructured":"Centers for Medicare & Medicaid Services \u201cList of Medicaid Eligibility Groups \u201dhttps:\/\/www.medicaid.gov\/sites\/default\/files\/2019\u201012\/list\u2010of\u2010eligibility\u2010groups.pdf."}],"container-title":["Health Services Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1475-6773.70053","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1475-6773.70053","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1475-6773.70053","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T11:07:33Z","timestamp":1772968053000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1475-6773.70053"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,7]]},"references-count":19,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1111\/1475-6773.70053"],"URL":"https:\/\/doi.org\/10.1111\/1475-6773.70053","archive":["Portico"],"relation":{},"ISSN":["0017-9124","1475-6773"],"issn-type":[{"value":"0017-9124","type":"print"},{"value":"1475-6773","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,7]]},"assertion":[{"value":"2024-12-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70053"}}