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Title: Saving Babies: The Efficacy and Cost of Recent Expansions of Medicaid Eligibility for Pregnant Women
Resulting in 1 citation.
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Currie, Janet Gruber, Jonathan |
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Saving Babies: The Efficacy and Cost of Recent Expansions of Medicaid Eligibility for Pregnant Women Working Paper 94-11, Department of Economics, Massachusetts Institute of Technology, December 1993 Cohort(s): Children of the NLSY79, NLSY79 Publisher: Department of Economics, Massachusetts Institute of Technology Keyword(s): Aid for Families with Dependent Children (AFDC); Armed Forces Qualifications Test (AFQT); Benefits, Insurance; Birthweight; Education; Health Reform; Mortality; Poverty; Pre-natal Care/Exposure; Pre/post Natal Behavior; Pre/post Natal Health Care; Pregnancy and Pregnancy Outcomes Permission to reprint the abstract has not been received from the publisher. A 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 1980's. 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 fairly cost effective compared to conventional estimates of the value of a life. We conclude that insurance expansions can improve health, but that translating eligibility to coverage may be the key link in making insurance policy effective. This record is part of the Abstracts of Working Papers in Economics (AWPE) Database, copyright (c) 1995 Cambridge University Press |
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Bibliography Citation
Currie, Janet and Jonathan Gruber. "Saving Babies: The Efficacy and Cost of Recent Expansions of Medicaid Eligibility for Pregnant Women." Working Paper 94-11, Department of Economics, Massachusetts Institute of Technology, December 1993. |