By NextBestFit12-month postpartum coverage and home visits
Guarantee coverage for a year after birth with nurse home visits.
Cheap, proven.
Review ledgerHow this path connects
This path
12-month postpartum coverage and home visits
Concrete changes if chosen
What would actually have to change in law, agencies, payment rules, or systems.
- Guarantee 12-month postpartum coverage
- Fund nurse home visits
Effects
Each effect has its own page: the evidence, the case that it is or isn't a real cost, and whom it affects.
What it fixes
- High maternal mortality and postpartum coverage gaps
Extended coverage after birth addresses the substantial share of pregnancy-related deaths occurring after delivery. Nurse home visits catch hypertension and depression early.
What it creates or worsens
- Nursing and direct-care shortages and burnout
Nurse home-visiting programs require trained nurses.
- Solves only part of the problem
Postpartum coverage alone does not fix shortages of postpartum care.
Who's affected
Who gains
- Pregnant and postpartum people and infants
- High maternal mortality and postpartum coverage gaps: High maternal mortality and postpartum coverage gaps especially harm Black women.
- Black, Hispanic, and Native communities
- High maternal mortality and postpartum coverage gaps: High maternal mortality and postpartum coverage gaps especially harm Black women.
- Health care staffing agencies
- Nursing and direct-care shortages and burnout: Shortages allow them to charge premium rates.
- Hospitals, clinics, and care organizations
- Nursing and direct-care shortages and burnout: Operators benefit from keeping staffing thin.
Who loses
- People with ongoing or specialist care needs
- Nursing and direct-care shortages and burnout: Understaffed hospitals and nursing homes leave them with too few caregivers.
- Older and disabled people needing long-term care
- Nursing and direct-care shortages and burnout: Understaffed hospitals and nursing homes leave them with too few caregivers.
- Doctors, nurses, and other clinicians
- Nursing and direct-care shortages and burnout: High turnover and low aide pay burden care workers.
Where it has been tried
- Most U.S. states (Medicaid): Extended postpartum Medicaid to 12 months.
- United States: A 2024 Commonwealth Fund report stated that 47 states had implemented 12-month postpartum Medicaid coverage extensions.Sources: Commonwealth Fund (2024)