Medicaid expansions and welfare contractions: offsetting effects on prenatal care and infant health?

J Health Econ. 2002 Mar;21(2):313-35. doi: 10.1016/s0167-6296(01)00125-4.


Most states have adopted administrative measures to encourage the use of prenatal care among medicaid-eligible women. At the same time, declining welfare caseloads have caused many women to lose medicaid. We examine the effects of changes in income eligibility, administrative procedures, and welfare caseloads using data from all birth certificates for 1990-1996. Higher income cutoffs increased use of prenatal care, while decreases in welfare caseloads reduced it. Changes in income cutoffs also reduced fetal deaths. These results suggest that the administrative reforms have not broken the close link between welfare participation and access to medicaid.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Birth Weight
  • Eligibility Determination / legislation & jurisprudence*
  • Female
  • Fetal Death
  • Health Services Accessibility
  • Humans
  • Infant, Low Birth Weight
  • Infant, Newborn
  • Medicaid / legislation & jurisprudence*
  • Outcome Assessment, Health Care*
  • Pregnancy
  • Pregnancy Outcome / economics
  • Pregnancy Outcome / epidemiology
  • Prenatal Care / economics*
  • Prenatal Care / standards*
  • Prenatal Care / statistics & numerical data
  • Quality Indicators, Health Care*
  • Risk Factors
  • Social Welfare
  • Socioeconomic Factors
  • United States / epidemiology