title: State And Federal Coverage For Pregnant Immigrants: Prenatal Care Increased, No Change Detected For Infant Health.
abstract: Expanded health insurance coverage for pregnant immigrant women who are in the United States lawfully as well as those who are in the country without documentation may address barriers in access to pregnancy-related care. We present new evidence on the impact of states' public health insurance expansions for pregnant immigrant women (both state-funded and expansions under the Children's Health Insurance Program) on their prenatal care use, mode of delivery, and infant health. Our quasi-experimental design compared changes in immigrant women's outcomes in states expanding coverage to changes in outcomes for nonimmigrant women in the same state and to women in nonexpanding states. We found that prenatal care use increased among all immigrant women following coverage expansion and that cesarean section increased among immigrant women with less than a high school diploma. We found no effects on the incidence of low birthweight, preterm birth, being small for gestational age, or infant death. State public insurance programs that cover pregnant immigrant women appear to have improved prenatal care utilization without observable changes in infant health or mortality.
authors.affiliation: Laura R. Wherry (LWherry@mednet.ucla.edu) is an assistant professor of medicine in the David Geffen School of Medicine, University of California, Los Angeles (UCLA).
authors.forename: Laura R
authors.initials: LR
authors.lastname: Wherry
authors.affiliation: Rachel Fabi is a doctoral candidate in health policy and management at the Johns Hopkins Bloomberg School of Public Health, in Baltimore, Maryland.
authors.forename: Rachel
authors.initials: R
authors.lastname: Fabi
authors.affiliation: Adam Schickedanz is a clinical instructor in pediatrics in the David Geffen School of Medicine at UCLA.
authors.forename: Adam
authors.initials: A
authors.lastname: Schickedanz
authors.affiliation: Brendan Saloner is an assistant professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health.
authors.forename: Brendan
authors.initials: B
authors.lastname: Saloner
mesh_terms: D000293:Adolescent; D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D065326:Children's Health Insurance Program / Q000706:statistics & numerical data; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D005380:Financing, Government / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D000068104:Infant Health / Q000706:statistics & numerical data*; D007231:Infant, Newborn; D019458:Insurance Coverage / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000706:statistics & numerical data; D008484:Medicaid; D011203:Poverty; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D014481:United States
keywords: Children’s Health Insurance Program; Immigrants; Maternal And Child Health; Medicaid; Prenatal Care