Comprehensive care throughout pregnancy promotes maternal and infant health through the identification and prevention of pregnancy complications, the management of chronic maternal disease, and promoting healthy birth spacing. Medicaid funds half of all pregnancy care in the United States (US). However, Medicaid coverage is highly restricted among US-based Latinas. By federal law, both undocumented and documented immigrants who have been in the US for less than five years are only eligible for Emergency Medicaid, a federal safety net program that covers emergency care only. Thus, Emergency Medicaid covers the cost of a delivery, but no prenatal or post-partum care. States can expand their Emergency Medicaid coverage to encompass prenatal and/or postpartum care, but we have no evidence about the impact of such policies. Oregon has implemented innovative policy that extends coverage from the prenatal period through 60 days postpartum. We will compare care utilization rates and interpregnancy interval Aim 1) between traditional Medicaid and Emergency Medicaid and Aim 2) within the Emergency Medicaid population between South Carolina (a no-coverage state) and Oregon. We will also estimate anticipated Medicaid costs and health benefits (Aim 3) of each coverage scenario. Our study will generate findings that can be used to guide policy nationally as to the health benefits and Medicaid costs of restricting access to pregnancy care.
This study evaluates the role of Medicaid policy in influencing maternal and newborn disparities among pregnant Latinas. We will compare birth certificate and Medicaid billing data from two states with divergent Medicaid pregnancy coverage for Latinas (Oregon and South Carolina). We measure the effect of these different policies on use of health care and a measure of healthy pregnancy. We also will estimate expected costs and benefits of each state's policy. Our study will provide important information about the health impact and costs of Medicaid policies that provide or restrict access to preventative care during pregnancy in an at risk population.