The Failure of Prenatal Care Policy for the Poor

Prologue: The 1980s witnessed a troubling rise in infant mortality rates in the United States, reversing a decades-long decline. Overall, the US. infant mortality rate ranks behind those of many other wealthy, developed nations; moreover, for minority populations and in certain regions of the country, the rates more closely resemble those of the Third World. By mid-decade, Congress had begun to act on the advice of numerous expert panels that convened to address infant mortality and related issues. A series of expansions of Medicaid eligibility began, the most recent of which was passed into law with the 1990 budget reconciliation legislation. In this article, Mark Schlesinger and Karl Kronebusch explore the extent to which policymakers may have “thrown out the baby with the bathwater' in attempting to improve infant mortality rates. They examine the links between low birthweight, infant mortality, and economic status. They charge that requiring states to expand Medicaid eligibility, while resulting in only minor improvements in access to care, may actually ”create counterproductive side effects that could outweigh the benefits of increased eligibility.