State And Federal Coverage For Pregnant Immigrants: Prenatal Care Increased, No Change Detected For Infant Health

Health Aff (Millwood). 2017 Apr 1;36(4):607-615. doi: 10.1377/hlthaff.2016.1198.

Abstract

Expanded health insurance coverage for pregnant immigrant women who are in the United States lawfully as well as those who are in the country without documentation may address barriers in access to pregnancy-related care. We present new evidence on the impact of states' public health insurance expansions for pregnant immigrant women (both state-funded and expansions under the Children's Health Insurance Program) on their prenatal care use, mode of delivery, and infant health. Our quasi-experimental design compared changes in immigrant women's outcomes in states expanding coverage to changes in outcomes for nonimmigrant women in the same state and to women in nonexpanding states. We found that prenatal care use increased among all immigrant women following coverage expansion and that cesarean section increased among immigrant women with less than a high school diploma. We found no effects on the incidence of low birthweight, preterm birth, being small for gestational age, or infant death. State public insurance programs that cover pregnant immigrant women appear to have improved prenatal care utilization without observable changes in infant health or mortality.

Keywords: Children’s Health Insurance Program; Immigrants; Maternal And Child Health; Medicaid; Prenatal Care.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Cesarean Section / statistics & numerical data
  • Children's Health Insurance Program / statistics & numerical data
  • Emigrants and Immigrants / statistics & numerical data*
  • Female
  • Financing, Government / statistics & numerical data*
  • Health Services Accessibility
  • Humans
  • Infant
  • Infant Health / statistics & numerical data*
  • Infant, Newborn
  • Insurance Coverage / statistics & numerical data
  • Insurance, Health / statistics & numerical data
  • Medicaid
  • Poverty
  • Pregnancy
  • Prenatal Care / statistics & numerical data*
  • United States