Access to Medicaid and Timely Prenatal Care

As the COVID-19 pandemic-related public health emergency ends, Medicaid policy expansions are beginning to unwind causing lasting ripple effects on who has continual access to health care. As the KFF mentions, an estimated 14 million people might lose Medicaid coverage as a result of the unwinding of the Families First Coronavirus Response Act (FFCRA) continuous enrollment provision.

Given the number of people who are at risk of losing healthcare coverage during the unwinding period, especially groups such as immigrants and people with certain disabilities, we are excited to share with you an article just published today in JAMA Network Open that examines the impact of Medicaid expansion on prenatal care and how it impacts immigrant vs US-born women differently.

Overall, we found that exclusions to Medicaid eligibility based on immigration status may increase maternal healthcare disparities in some immigrant populations. In particular, access to timely prenatal care increased in states that expanded Medicaid as part of the Affordable Care Act. However, this increased access to timely prenatal care was among US-born but not immigrant Asian and Hispanic women. Further, the results were most pronounced among Hispanic and Asian women without a college degree. This “left behind effect” remained after controlling for time-varying state-level poverty, unemployment, and policies toward immigrants. Our findings suggest that citizen-based exclusions to health care and social benefits contribute to structural racism immigrant communities face. Also, the results from this study demonstrate that certain restrictions on Medicaid coverage based on immigration status contribute to disparities between US-born and immigrant people seeking timely prenatal care.

To read the article, click here.

To cite this article: Janevic T, Weber E, Howell FM, Steelman M, Krishnamoorthi M, Fox A. Analysis of State Medicaid Expansion and Access to Timely Prenatal Care Among Women Who Were Immigrant vs US Born. JAMA Network Open. 2022 Oct 3;5(10):e2239264-.

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