The effects of pregnancy-related Medicaid expansions on maternal, infant, and child health

Prior research has examined how late 1980s pregnancy-related Medicaid eligibility expansions influenced outcomes around the time of birth and, more recently, adult outcomes. We offer a close examination of early childhood effects to better understand the mechanism(s) underlying the improved longer-term outcomes. The restricted-access National Maternal and Infant Health Survey allows us to explore the effects of these expansions on maternal and child outcomes near the time of birth as well as three years post-birth. Our evidence suggests earlier connection with prenatal care and possible modest improvements in birthweight and gestational age. In our follow-up data, we also identify evidence of persistent effects as measured by child developmental scores. However, the most consistent finding is our strong evidence of reduced levels of maternal depression—both during the child's infancy and three years later. We conclude that the alleviation of maternal stress is one likely mechanism for the longer-term improvements in later-life outcomes identified in studies of children exposed to Medicaid in-utero and in early infancy.