Medicaid Expansion Linked to Positive Earnings for Black Babies

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Prematurity and underweight at birth can expose an infant to a significant risk of death. In 2013, about 36% of infant deaths were due to causes related to prematurity, according to an article published in the 2015 Vital Statistics reports.

Still, the new study shows that the expansion of Medicaid was linked to the reduction of this gap.

"This is one more piece of the puzzle that highlights the health gains from Medicaid's expansion, particularly in some populations," said J. Mick Tilford, professor and director of policy and management of Medicaid. health at the University of Arkansas for medical science in Little Rock. who was the main author of the study.

"We believe these findings should be taken into account in calculating by decision makers the opportunity to extend Medicaid or not," he said.

No matter who is eligible for Medicaid based on their income, size, disability, family status and other factors, but the ACA allows states to expand the drug coverage. eligibility of Medicaid so that residents can claim only if their household income level is below federal poverty. line.

"We hypothesized that health insurance would improve the health of mothers," Tilford said.

"If mothers had more health insurance and better health, it would affect the health of the baby.This is what explains the results of this study, it's the healthier mother," did he declare. "There are many factors that affect low birth weight, but nothing compares to these differences in results by race."

Effect between 5% and 15% & # 39;

Researchers analyzed birth certificate data for more than 15 million births in women aged 19 and over in the District of Columbia, 18 states that expanded Medicaid, and 17 others. The data, which are from 2011 to 2016, come from the vital statistics system of the National Center for Health Statistics.

The researchers looked closely at the health consequences of low birth weight, prematurity, a very low birth weight and a very premature birth, in black, white and Hispanic infants. They then compared the results in states that extended Medicaid to those states that did not.

These are the states where infant mortality is highest

Overall, the data showed no difference in birth outcomes between expanding states and others. However, the differences in outcome rates in black infants compared to white infants in the Medicaid Expansion states decreased, with improvements seen in black infants for all four outcomes.

"The size of effect for expanding black infants was between 5% and 15%," Tilford said.

The researchers found that relative disparities were not altered for Hispanic children, but that for black children, "these cuts potentially have a significant impact on the lives of black children," Clare Brown said. , public health professor at the University of Toronto. Arkansas for Medical Sciences, who was the first author of the study.
Newborn stillbirths and deaths in the United States are down 11.5%, according to one study

The study had some limitations, particularly because it was based on the birth data files and was vulnerable to the limitations identified in this dataset.

"There are a lot of variables that we would like to be able to control, so a great solution would have been to be able to specifically look at low-income women," said Brown.

"The birth certificate data do not know whether a woman, for example, has an income below 138% of the federal poverty line, which would make her eligible for Medicaid for the Medicaid extension," she said. she said.

A "major public health problem"

This is not the only study to find a significant association between Medicaid's expansion and some health outcomes.

Medicaid Expansion Linked to Fewer Heart-Related Deaths, Study Reveals
Researches presented at the American Heart Association's scientific sessions this month revealed that between 2010 and 2016, the counties in the states where Medicaid had expanded had registered 4 fewer deaths per year per 100,000 population for cardiovascular reasons compared to counties in non-expansive states.
Dr. Heather Burris, neonatologist at the Children's Hospital of Philadelphia and assistant professor of pediatrics at the University of Pennsylvania's Perelman School of Medicine, described the new study as "elegant design."

"The investigators found that although expansion was not associated with overall differences in birth outcomes, there was a reduction in disparities between blacks and whites, which is historically very hard to do, "said Burris, who did not participate in the study.

She added that the disparities highlighted in the study remained "a major public health problem".

Childbirth kills black women in the United States, and here's why

For example, antenatal care received in the first trimester remains low for black women in the two expanding states (67%) and the non-expanding states (64%), compared to 81% for white women and 78% for women. %, respectively.

"These persistent disparities show that more than access to health care is needed to address racial disparities in childbirth," she said.

The expansion of Medicaid could influence the outcome of pregnancy in many ways, including improving women's access to prenatal care, said Michael Kramer, associate professor of psychology and health. Epidemiology at the Rollins School of Public Health at Emory University in Atlanta, who did not participate in the study.

In addition, "one mechanism by which the expansion of Medicaid could help is to support more consistent and comprehensive family planning," Kramer said.

"Finally, we believe that differences in the health of women even before they are pregnant, are at the root of important causes of all outcomes – as well as causes of racial disparities – , did he declare.

"The benefits of consistent access to health insurance and health care can accumulate over the years to improve the health of women in general, which would translate into improved outcomes." of pregnancy, but might not be obvious with only one or two years of status of expansion, "he said. . "In other words, it's critical that we continue to evaluate the longer-term impacts of Medicaid extensions."

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