Medicaid and pregnancy: issues in expanding eligibility

Recent federal and state policy has expanded Medicaid eligibility to provide health insurance coverage for pregnant women with family incomes below 133 percent of the federal poverty level. It has yet to be determined how such expanded coverage will affect enrollment in Medicaid or use of prenatal care. Using 1983 data from three states with widely divergent Medicaid programs--including one that already had most of the expanded eligibility options available today--this study found that about 40-60 percent of women who were covered by Medicaid at the time of their deliveries had not been enrolled in the program when they became pregnant. In addition, a large number of women did not receive Medicaid-covered prenatal care early in pregnancy, even though they were enrolled at that time. Almost all women in the study group visited more than one ambulatory care provider at some time during the nine months before birth and one year following birth; 29-51 percent visited more than one hospital outpatient department.