Day 45 – Medicaid at 50: Reducing infant mortality

Over the coming weeks this blog will highlight a key feature of Medicaid and the individual states that administer Medicaid and CHIP leading up the the program’s 50th anniversary (July 30th). Hopefully, you’ll learn some interesting facts about Medicaid and each of the 51 state programs.

db120_fig5
Source: CDC

The infant mortality rate (IMR) in the United States is much higher than than most industrialized nations; the gap is worst for babies born at term (37+ weeks), where U.S. ranks last. Within the U.S., there is a lot of geographic variation in infant mortality, and there are major racial and ethnic disparities.

In the 1980s and early 1990s, there was a big expansion of Medicaid coverage for pregnant women. (Previously, Medicaid eligibility was tied to AFDC.) This expansion offered the chance to study how Medicaid coverage affected infant health: according to this study, a 30% increase in Medicaid coverage for pregnant women resulted in a 8.5% decline in the infant mortality rate.

Access to preconception and early prenatal care plays an important role in reducing infant mortality. Pregnancy is now one of the most generous (relatively) Medicaid income eligibility categories – although some states are set at 138% of the Federal Poverty Level (FPL), some go as high as 380% of FPL (shout out to Iowa!), and more than half of states have coverage thresholds at 200%+ FPL.

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