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Beyond Being Insured: Insurance Coverage Denial as a Major Barrier to Accessing Care During Pregnancy and Postpartum

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  • Jusung Lee
  • Krista J. Howard
  • Caleb Leong
  • Timothy J. Grigsby
  • Jeffrey T. Howard

Abstract

This study investigates the association between insurance coverage denial and delays in care during pregnancy and postpartum. An online survey was administered in March and April 2022 to women who were either pregnant or within 1 year postpartum ( n  = 1,113). The outcome was delayed care, measured at four time points: during pregnancy and 1 week, 2 to 6 weeks, and after 7 weeks postpartum. The key covariate was insurance coverage denial by providers during pregnancy. Delayed care due to having an unaccepted insurance and being “out-of-network†was more pronounced at 1 week postpartum with 3.37 times and 3.47 times greater odds and in 2 to 6 weeks postpartum with 5.74 times and 2.97 times greater odds, respectively. The association between insurance denial and delays in care encapsulated transportation, rural residency, time issues, and financial constraints. The findings suggest that coverage denial is associated with significant delays in care, providing practical implications for effective perinatal care.

Suggested Citation

  • Jusung Lee & Krista J. Howard & Caleb Leong & Timothy J. Grigsby & Jeffrey T. Howard, 2023. "Beyond Being Insured: Insurance Coverage Denial as a Major Barrier to Accessing Care During Pregnancy and Postpartum," Clinical Nursing Research, , vol. 32(8), pages 1092-1103, November.
    • Handle: RePEc:sae:clnure:v:32:y:2023:i:8:p:1092-1103
    DOI: 10.1177/10547738231177332
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    References listed on IDEAS

    as
    1. Han, X. & Call, K.T. & Pintor, J.K. & Alarcon-Espinoza, G. & Simon, A.B., 2015. "Reports of insurance-based discrimination in health care and its association with access to care," American Journal of Public Health, American Public Health Association, vol. 105, pages 517-525.
    2. Krista J. Howard & Caleb Leong & Sidney Chambless & Timothy J. Grigsby & Millie Cordaro & Jessica K. Perrotte & Jeffrey T. Howard, 2022. "Major Depression in Postpartum Women during the COVID-19 Pandemic: Can Social Support Buffer Psychosocial Risks and Substance Use?," IJERPH, MDPI, vol. 19(23), pages 1-13, November.
    3. Loewenstein, George & Friedman, Joelle Y. & McGill, Barbara & Ahmad, Sarah & Linck, Suzanne & Sinkula, Stacey & Beshears, John Leonard & Choi, James J. & Kolstad, Jonathan & Laibson, David I. & Madria, 2013. "Consumers’ Misunderstanding of Health Insurance," Scholarly Articles 17190506, Harvard University Department of Economics.
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