
19: The Weekly Dose from Patient Care: How Medicaid Policies Impact Postpartum Depression Care
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Key Points:
- More robust Medicaid coverage leads to higher rates of PPD diagnosis.
This is not indicative of higher prevalence, but rather of improved access and identification of women in need of care.
- Medicaid policy changes during the COVID-19 pandemic offer a natural experiment.
When postpartum Medicaid coverage was expanded nationally, diagnosis rates rose. After the expansion ended, diagnoses dropped—likely due to decreased access, not decreased incidence.
- Universal screening should be standard clinical practice.
Mollard recommends screening beyond the six-week postpartum visit and ensuring continuity of care for those who screen positive.
- Medicaid must support a full range of postpartum mental health services.
Coverage should include not only screening, but also counseling, medications like zuranolone, and extended eligibility through 12 months postpartum.
- Policy gaps leave many women uninsured at a vulnerable time.
Many working women earn too much to qualify for Medicaid but too little to afford private insurance, making extended postpartum coverage essential to reduce disparities and prevent worsening mental health outcomes.
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