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

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  • Currie, Janet
  • Grogger, Jeffrey

Abstract

Evaluations of changes to the Medicaid program have focused on increases in the generosity of income cutoffs for Medicaid eligibility. Previous research shows that despite dramatic increases in the number of births paid for by the Medicaid program, women often enroll in Medicaid at the point of birth rather than before. States have addressed this problem by adopting administrative measures designed to simplify the Medicaid application process and encourage the use of prenatal care. At the same time, recent declines in welfare caseloads may effectively increasing administrative barriers to obtaining care. We examine the effects of these three types of policies (changes in income eligibility, administrative reforms, and changes in welfare caseloads) on the use of prenatal care and infant health using data from birth certificates covering all U.S. births between 1990 and 1996. We find that increases in income cutoffs increased the use of prenatal care, while decreases in welfare caseloads reduced the use of prenatal care, especially among blacks. The administrative reforms we consider had little effect. The changes in the utilization of prenatal care that were induced by increases in income eligibility cutoffs and decreases in welfare rates led to small but statistically significant reductions in the incidence of very low birthweight among whites.

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Bibliographic Info

Article provided by Elsevier in its journal Journal of Health Economics.

Volume (Year): 21 (2002)
Issue (Month): 2 (March)
Pages: 313-335

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Handle: RePEc:eee:jhecon:v:21:y:2002:i:2:p:313-335

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Web page: http://www.elsevier.com/locate/inca/505560

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References

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  2. Michael Grossman & Steven Jacobowitz, 1981. "Variations in infant mortality rates among counties of the United States: The roles of public policies and programs," Demography, Springer, vol. 18(4), pages 695-713, November.
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  4. Jeffrey Grogger, 2004. "Time Limits and Welfare Use," Journal of Human Resources, University of Wisconsin Press, vol. 39(2).
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  9. Currie, J. & Thomas, D., 1995. "Medical Care for Children, Public Insurance, Private Insurance, and Racial Differences in Utilization," Papers 95-08, RAND - Reprint Series.
  10. Currie, Janet & Gruber, Jonathan, 2001. "Public health insurance and medical treatment: the equalizing impact of the Medicaid expansions," Journal of Public Economics, Elsevier, vol. 82(1), pages 63-89, October.
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  14. Dubay, Lisa & Kaestner, Robert & Waidmann, Timothy, 2001. "Medical malpractice liability and its effect on prenatal care utilization and infant health," Journal of Health Economics, Elsevier, vol. 20(4), pages 591-611, July.
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  16. Currie, Janet & Gruber, Jonathan, 1996. "Saving Babies: The Efficacy and Cost of Recent Changes in the Medicaid Eligibility of Pregnant Women," Journal of Political Economy, University of Chicago Press, vol. 104(6), pages 1263-96, December.
  17. Janet Currie & Lucia Nixon & Nancy Cole, 1993. "Restrictions on Medicaid Funding of Abortion: Effects on Pregnancy Resolutions and Birth Weight," NBER Working Papers 4432, National Bureau of Economic Research, Inc.
  18. Mark R. Rosenzweig & T. Paul Schultz, 1982. "The Behavior of Mothers as Inputs to Child Health: The Determinants of Birth Weight, Gestation, and Rate of Fetal Growth," NBER Chapters, in: Economic Aspects of Health, pages 53-92 National Bureau of Economic Research, Inc.
  19. Jeffrey Grogger & Charles Michalopoulos, 2003. "Welfare Dynamics under Time Limits," Journal of Political Economy, University of Chicago Press, vol. 111(3), pages 530-554, June.
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