The Weekly Dose: How Medicaid Policies Impact Postpartum Depression Care

In this episode of The Weekly Dose, Patient Care editors spoke with Elizabeth Mollard, PhD, about new research she presented at the 2025 American College of Obstetricians and Gynecologists (ACOG) Annual Clinical & Scientific Meeting that highlighted how Medicaid policy directly impacts postpartum depression (PPD) diagnosis rates. Drawing on national data, Mollard explains that more generous Medicaid coverage—especially extended postpartum eligibility—leads to more frequent diagnoses of PPD, a finding that underscores the critical importance of access to care. The conversation covers clinical implications, the effects of the COVID-19-era Medicaid expansion and wind-down, and practical recommendations for clinicians and policymakers to improve mental health outcomes for postpartum patients.

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.