Saving Babies: The Efficacy and Cost of Recent Expansions of Medicaid Eligibility for Pregnant Women
AbstractA key question for health care reform in the U.S. is whether expanded health insurance eligibility will lead to improvements in health outcomes. We address this question in the context of dramatic expansions in the Medicaid eligibility for pregnant women that took place during the 1980s. We build a detailed simulation model of each state's Medicaid policy during the 1979-1990 period, and use this model to estimate 1) the effect of changes in the rules on the eligibility of pregnant women for Medicaid, and 2) the effect of Medicaid eligibility changes on birth outcomes in aggregate Vital Statistics data. We have three main findings. First, the expansions did dramatically increase the Medicaid eligibility of pregnant women, but did so at quite differential rates across the states. Second, the expansions lowered the incidence of infant mortality and low birthweight; we estimate that the 20 percentage point increase in eligibility among 15-44 year old women was associated with a decrease in infant mortality of 7%. Third, earlier, targeted changes in Medicaid eligibility, such as through relaxations of the family structure requirements from the AFDC program, had much larger effects on birth outcomes than broader expansions of eligibility to all women with somewhat higher income levels. We suggest that the source of this difference was the much lower takeup of Medicaid coverage by individuals who became eligible under the broader expansions. We find that the targeted expansions, which raised Medicaid expenditures by $1.7 million per infant life saved, were in line with conventional
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Date of creation: Feb 1994
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- Gruber, J. & Currie, J., 1994. "Saving Babies: The Efficacy and Cost of Recent Expansions of Medicaid Eligibility for Pregnant Women," Working papers 94-11, Massachusetts Institute of Technology (MIT), Department of Economics.
- H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
- J12 - Labor and Demographic Economics - - Demographic Economics - - - Marriage; Marital Dissolution; Family Structure
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- A. S. Yelowitz, .
"The Medicaid notch, labor supply, and welfare participation: Evidence from eligibility expansions,"
Institute for Research on Poverty Discussion Papers
1084-96, University of Wisconsin Institute for Research on Poverty.
- Yelowitz, Aaron S, 1995. "The Medicaid Notch, Labor Supply, and Welfare Participation: Evidence from Eligibility Expansions," The Quarterly Journal of Economics, MIT Press, vol. 110(4), pages 909-39, November.
- Aaron Yelowitz, 1995. "The Medicaid Notch, Labor Supply and Welfare Participation: Evidence from Eligibility Expansions," UCLA Economics Working Papers 738, UCLA Department of Economics.
- Rebecca Blank & David Card & Whitney Newey, 1988.
"Recent Trends in Insured and Uninsured Unemployment: Is There an Explanation?,"
623, Princeton University, Department of Economics, Industrial Relations Section..
- Blank, Rebecca M & Card, David E, 1991. "Recent Trends in Insured and Uninsured Unemployment: Is There an Explanation?," The Quarterly Journal of Economics, MIT Press, vol. 106(4), pages 1157-89, November.
- Rebecca M. Blank & David Card, 1989. "Recent Trends in Insured and Uninsured Unemployment: Is There an Explanation?," NBER Working Papers 2871, National Bureau of Economic Research, Inc.
- Currie, Janet & Cole, Nancy, 1993.
"Welfare and Child Health: The Link between AFDC Participation and Birth Weight,"
American Economic Review,
American Economic Association, vol. 83(4), pages 971-85, September.
- Currie, J. & Cole, N., 1992. "Welfare and Child Health: the Link Between AFDC Participation and Birth Weight," Working papers 92-9, Massachusetts Institute of Technology (MIT), Department of Economics.
- Cropper, Maureen L & Oates, Wallace E, 1992. "Environmental Economics: A Survey," Journal of Economic Literature, American Economic Association, vol. 30(2), pages 675-740, June.
- Stephen Chaikind & Hope Corman, 1990. "The Special Education Costs of Low Birthweight," NBER Working Papers 3461, National Bureau of Economic Research, Inc.
- Michael Grossman & Steven Jacobowitz, 1982. "Variations in Infant Mortality Rates among Counties in the United States: The Roles of Social Policies and Programs," NBER Working Papers 0615, National Bureau of Economic Research, Inc.
- Jeffrey E. Harris, 1982. "Prenatal Medical Care and Infant Mortality," NBER Chapters, in: Economic Aspects of Health, pages 13-52 National Bureau of Economic Research, Inc.
- 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.
- Moffitt, Robert, 1992. "Incentive Effects of the U.S. Welfare System: A Review," Journal of Economic Literature, American Economic Association, vol. 30(1), pages 1-61, March.
- Hope Corman & Theodore J. Joyce & Michael Grossman, 1987. "Birth Outcome Production Functions in the U.S," NBER Working Papers 1729, National Bureau of Economic Research, Inc.
- Mark R. Rosenzweig & T. Paul Schultz, 1988. "The Stability of Household Production Technology: A Replication," Journal of Human Resources, University of Wisconsin Press, vol. 23(4), pages 535-549.
- Cropper, Maureen L. & William N. Evans & Stephen J. Berard & Maria M. Ducla-Soares & Paul R. Portney, 1992. "The Determinants of Pesticide Regulation: A Statistical Analysis of EPA Decision Making," Journal of Political Economy, University of Chicago Press, vol. 100(1), pages 175-97, February.
- Bruce D. Meyer, 1989. "A Quasi-Experimental Approach to the Effects of Unemployment Insurance," NBER Working Papers 3159, National Bureau of Economic Research, Inc.
- 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.
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