Effects of Medicaid Eligibility Expansion on Prenatal Care and Pregnancy Outcome in Tennessee

Key Points

• To evaluate the impact of expanded Medicaid eligibility for married pregnant women on prenatal care utilization, infant birth weight, and neonatal mortality.
• Linked state vital statistics records to Medicaid enrollment files following a 1985 regulatory expansion in Tennessee targeting married pregnant women.
• Evaluated shifts in enrollment rates, timing of enrollment relative to trimester, early prenatal care initiation, birth weight, and neonatal mortality across demographic subgroups.
• Medicaid enrollment increased most among white married women under 25 years with less than 12 years of education, rising by 18% in enrollment rates.
• Expanded coverage produced no improvements in the use of early prenatal care, birth weight, or neonatal mortality among high-enrollment subgroups or the total population.
• More than two thirds of women who gained coverage enrolled after the first trimester of pregnancy.