Preconception and Prenatal Medicaid Coverage for Medicaid-Insured Births

Area of Science:

• Health Services Research
• Public Health
• Health Economics

Background:

• Medicaid insures a significant portion of U.S. births, approximately 40%.
• Understanding preconception Medicaid enrollment patterns is essential for public health initiatives.
• Existing data lacks detailed descriptions of Medicaid enrollment prior to birth.

Purpose of the Study:

• To describe patterns of Medicaid enrollment in the 84 months preceding a birth insured by Medicaid.
• To identify factors associated with the duration and stability of preconception Medicaid enrollment.
• To examine state-level variations in Medicaid enrollment dynamics.

Main Methods:

• Retrospective cohort study using Medicaid Analytic Extract files.
• Analysis of 944,068 individuals with a 2014 Medicaid-insured birth across 30 states.
• Linear regression to assess associations between enrollment months and demographic, health, and state-level factors.

Main Results:

• Individuals had a median of 40.6 months of Medicaid enrollment with 3.2 status changes.
• Twenty-eight percent had continuous Medicaid enrollment for at least 63 months.
• Age, race/ethnicity, and chronic conditions (hypertension, diabetes, mental health) were significantly associated with enrollment duration.

Conclusions:

• Medicaid is a vital source of preconception health insurance for individuals giving birth with Medicaid coverage.
• Younger individuals and those with chronic health conditions demonstrate longer Medicaid enrollment periods.
• State-specific variations in enrollment patterns and status changes warrant further investigation.