Does Medicaid Expansion Improve Maternal and Infant Health?

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David Geffen School of Medicine, University of California, Los Angeles

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Recent media reports have highlighted startling trends in U.S. maternal health with stark differences across racial and ethnic groups. Maternal deaths associated with pregnancy and childbirth are high when compared to other developed countries and have increased substantially over the last two decades.

While efforts have been made to improve care during pregnancy, there is growing recognition that access to care prior to pregnancy and after childbirth is critically important for the health of a woman and her infant.

Expanding health insurance coverage for low-income women is an important policy lever to increase access to affordable health care during these critical periods, but there is little existing evidence linking health insurance to improved maternal health outcomes.

This study will clarify the role of insurance by measuring the effects of expanded health insurance coverage for low-income women, and determining whether there are differential effects for mothers with different racial and ethnic backgrounds. The research team will:

  1. Investigate the effect of the ACA Medicaid expansions on health insurance coverage for low-income women before, during, and after pregnancy;
  2. Determine whether there are corresponding changes in the use of health care and health behaviors; and,
  3. Evaluate whether these changes translate into improvements in maternal and newborn health.

Understanding the mechanisms by which expanded health insurance may improve maternal and infant health outcomes is critical to crafting successful policies and interventions that bridge health services and systems to effectively address population disparities.