The Impact of the Medicaid Expansions for Pregnant Women: A Synthesis of the Evidence

Howell, Embry

doi:10.1177/107755870105800101

Cited by 100 publications

(75 citation statements)

References 18 publications

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“…However, evidence on Medicaid's impact on health and mortality has been mixed. Currie & Gruber (1996a, 1996b showed that expansions of Medicaid eligibility to pregnant women and children in the 1980s led to reductions in infant mortality and children's mortality, though others (Epstein & Newhouse, 1998;Howell, 2001) found little or no effect. In another recent paper, the initial implementation of Medicaid in the late 1960's was linked to a 40% individual-level reduction in infant and child mortality for non-whites (Goodman-Bacon, 2013).…”

Section: Previous Literaturementioning

confidence: 99%

State Medicaid Expansions and Mortality, Revisited: A Cost-Benefit Analysis

Sommers¹

2017

American Journal of Health Economics

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Previous research found that Medicaid expansions in New York, Arizona, and Maine in the early 2000's reduced mortality. I revisit this question with improved data and methods, exploring distinct causes of death and presenting a cost-benefit analysis. Differences-in-differences analysis using a propensity-score control group shows that all-cause mortality declined by 6%, with the most robust reductions for healthcare-amenable causes. HIV-related mortality (affected by the recent introduction of antiretrovirals) accounted for 20% of the effect. Mortality changes were closely linked to county-level coverage gains, with one life saved annually for every 239-316 adults gaining insurance. The results imply a cost-per-life saved ranging from $327,000 to $867,000, which compares favorably to most estimates of the value of a statistical life.

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Section: Previous Literaturementioning

confidence: 99%

State Medicaid Expansions and Mortality, Revisited: A Cost-Benefit Analysis

Sommers¹

2017

American Journal of Health Economics

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“…Howell (2001) reviews the literature examining the impact of Medicaid expansions on infant outcomes. 2.…”

Section: Notesmentioning

confidence: 99%

Medicaid Coverage and Medical Interventions During Pregnancy

Turcotte

Robst

Polachek

2005

Int J Health Care Finance Econ

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This paper extends prior research on the effect of Medicaid coverage on medical interventions during pregnancy (prenatal ultrasound) and birth (ultrasound during delivery, cesarean delivery, inducement, and fetal monitor). The data are from two sources: the New York State Vital Statistics (VS) matched infant birth-death file and the Statewide Planning and Research Cooperative System (SPARCS) file for 1993--1996. Medicaid coverage increases the likelihood of teens and adults receiving prenatal care relative to being uninsured. Overall, the effect of insurance type varies depending on whether the procedure is part of standard care (ultrasound and fetal monitor) or more likely to be elective (inducement and cesarean delivery). Insurance type has a greater effect for elective procedures than for procedures that are part of standard care.

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“…For 2004, unrevised (4). These gains may be linked in part to the expansion of Medicaid for pregnant women in the late 1980s (65,66). Despite improvements in recent years among groups with lower levels of care, large disparities persist.…”

Section: Medical Services Utilization Prenatal Carementioning

confidence: 99%

Hippocratic ideal, Faustian bargain and Damocles' sword: erosion of patient autonomy in obstetrics

Rybak

2009

J Perinatol

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Objectives-This report presents 2004 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal lifestyle and health characteristics (medical risk factors, weight gain, and tobacco use); medical care utilization by pregnant women (prenatal care, obstetric procedures, characteristics of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's state of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant characteristics are described and interpreted.Methods-Descriptive tabulations of data reported on the birth certificates of the 4.1 million births that occurred in 2004 are presented.

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The Impact of the Medicaid Expansions for Pregnant Women: A Synthesis of the Evidence

Cited by 100 publications

References 18 publications

State Medicaid Expansions and Mortality, Revisited: A Cost-Benefit Analysis

State Medicaid Expansions and Mortality, Revisited: A Cost-Benefit Analysis

Medicaid Coverage and Medical Interventions During Pregnancy

Hippocratic ideal, Faustian bargain and Damocles' sword: erosion of patient autonomy in obstetrics

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