Objective: To estimate the costs of expanding Emergency Medicaid coverage to include postpartum contraception. Methods: A decision-analytic model was developed using three perspectives: the hospital, state Medicaid programs, and society. Our primary outcome was future reproductive health care costs due to pregnancy in the next 5 years. A Markov structure was use to analyze the probability of pregnancy over a 5-year time period. Model inputs were retrieved from the existing literature and local hospital and Medicaid data related to reimbursements. One-way and multiway sensitivity analyses were conducted. A Monte Carlo simulation was performed to incorporate uncertainty from all of the model inputs simultaneously. Results: Over a 5-year period, provision of contraception would save society $17,792 per woman in future pregnancy costs and incur a loss of $367 for hospitals. In states in which 49% of immigrants remain in the area for 5 years, such a program would save state Medicaid $108 per woman. Conclusion: Under federal regulations, new immigrants are restricted to acute, hospital-based care only. Failure to provide the option of contraception postpartum results in increased costs for society and states with long-term immigrants. © 2010 by The American College of Obstetricians and Gynecologists. Published by Lippincott Williams & Wilkins.

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immigrant Family Planning Services human medical society priority journal financial management United States health care cost health program Humans Emigrants and Immigrants female Contraception Monte Carlo Method Article pregnancy outcome adult medicaid postnatal care medical decision making cost-benefit analysis puerperium