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CMS Releases Infographic Highlighting Medicaid and Children’s Health Insurance Program Beneficiaries

According to an infographic recently released by the Centers for Medicare & Medicaid Services (CMS), 41% of U.S. births were paid for by Medicaid in 2021 and 26% of the 92.1 million Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries were ages 15 to 49. The infographic, which draws attention to maternal and infant health disparities, goes on to provide an overview of Medicaid and CHIP, including demographics, access to care, health status, health outcomes, risk factors, and healthcare utilization among beneficiaries seeking pregnancy-related care and those with a recent live birth.

Severe Maternal Morbidity and Mortality

Defined as unexpected outcomes of labor and delivery that result in significant consequences to the mother’s health, severe maternal morbidity (SMM) has been steadily increasing in recent years, along with the rate of maternal deaths. SMM is affecting Black non-Hispanic/Latino mothers at a much higher rate, indicating disparities by race and ethnicity.

As the graph indicates, the U.S. mortality rate per 100,000 live births was 69.9 for Black non-Hispanic/Latino mothers in 2021, compared with 28.0 for Hispanics/Latino mothers and 26.6 for White non-Hispanic/Latino mothers.

Other key findings include:

• Of the available data from 39 states and D.C., there were 43,600 Medicaid and CHIP deliveries with a SMM condition in 2021.
• The top three underlying causes of pregnancy related deaths in 36 states between 2017 and 2019 were: behavioral health conditions, 22.7%; hemorrhage, 13.7%; and cardiac and coronary conditions, 12.8%.

Behavioral Health and Substance Use

According to all-payer data from 36 states, the leading underlying cause of pregnancy-related deaths from 2017 to 2019 was behavioral health conditions, including substance use disorders.

The graph below shows the percentage of female Medicaid and CHIP beneficiaries ages 18-49 who reported receiving behavioral health treatment in 2021:

Key findings include:

• 88% of beneficiaries with a live birth in 2020 reported being screened for depression at their postpartum visit.
• The rate of Neonatal Abstinence Syndrome diagnoses is 14.6 per 1,000 Medicaid and CHIP deliveries in 2021.
• 12% of beneficiaries covered by Medicaid, CHIP, or state-sponsored health plans with a live birth in 2020 reported smoking cigarettes during the last 3 months of pregnancy.
• 19% of female Medicaid and CHIP beneficiaries ages 14-49 reported substance use disorders for alcohol or illicit drugs during the past year 2021. Adults ages 18-49 reported significantly higher rates than adolescents ages 14-17.

Causes of Maternal Mortality

While overall, behavioral health was the leading underlying cause of death, a look further into the data reveals significant differences in race and ethnicity. For Hispanic/Latino and White non-Hispanic/Latino populations, the top underlying causes of pregnancy-related deaths were behavioral health conditions, hemorrhage and, tied for third, infection and cardiac and coronary conditions. However, for the Black non-Hispanic/Latino population, the top cause was cardiac and coronary conditions, followed by cardiomyopathy and thrombotic embolism.

Prenatal and Postpartum Care

The American College of Obstetricians and Gynecologists (ACOG) recommends that all birthing individuals receive comprehensive prenatal care, including an oral health assessment and screening for psychosocial and other risk factors. It is also recommended that birthing individuals should also have contact with their obstetric care providers within the first three weeks postpartum and be followed up with ongoing care as needed. This timely care is an important step in catching pregnancy-related health conditions that can harm the health of birthing individuals. Unfortunately, these visits do not always occur in the recommended timeframe, if at all.

The ACOG recommends comprehensive postpartum care within 12 weeks after birth to assess physical recovery from pregnancy and childbirth and address chronic health conditions, social and psychological well-being, and family planning.

Other key findings include:

• Percentage of postpartum women covered by Medicaid or CHIP who were provided contraception within 60 days of delivery in 2021: 39.4% of women ages 15-20 and 38.6% of women ages 21-44 were provided a most or moderately effective method of contraception.
• Percentage of postpartum women covered by Medicaid or CHIP who were provided contraception within 60 days of delivery in 2021: 15.3% of women ages 15-20 and 11.7% of women ages 21-44 were provided a long-acting reversible method of contraception.
• 30% of singleton (one fetus), not first-time births covered by Medicaid in 2021 were conceived less than 18 months after a previous birth.

You can view the full infographic by visiting www.medicaid.gov.