The federal Personal Responsibility and Work Opportunity Reform Act of 1996 (PRWORA) ended the ability of legal immigrants, who entered the US after August 22, 1996, to obtain federally funded Medicaid no-emergency care, including prenatal care, for at least five years. Prior to the passage of the PRWORA, legal immigrants were eligible for prenatal care if they qualified for Medicaid on the basis of their low incomes and assets. This project studies the impact of this Act on the prenatal care and health outcomes for infants born to low-income foreign-born Hispanic women in Texas. It compares the changes in the use of pre-natal care and health outcomes for infants born to foreign-born Hispanic women, who are more likely to be affected by the Act, relative to infants born to US-born Hispanic women, who are less likely to be affected by the Act, between the periods before and after the Act. It improves upon previous studies in three ways: (1) by studying Texas, which did not use state funds to buffer PWRORA's impact, (2) by studying the potential spatial variation in the impact of PWRORA in relation to distance to prenatal care providers and (3) in relation to the proportion of post-1996 immigrants at the census tract level. I use a unique confidential database of birth certificates and linked birth-death certificates of all infants that has been geo-coded to the census tract level for the years [1991-2001] for Texas. I measure the distance of the centroid of each census tract to the nearest prenatal care.
