Medicaid covers nearly half of births

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Nearly half of American babies, and a third of those born in Pennsylvania, are born to mothers receiving Medicaid benefits, according to a study issued this week.

Those figures are higher than previous estimates, and demonstrates not only that the Medicaid program is the single largest payer of obstetric care in the U.S., but also confirms that most American newborns are born into some degree of poverty.

Medicaid is the state-operated health insurance program for the poor.

"Frankly, we've never had a really solid handle on the percentage of births covered by Medicaid," said Cynthia Pellegrini, senior vice president for public policy and government affairs at the March of Dimes, which teamed with researchers at George Washington University to carry out the study.

"It sounds like it ought to be a relatively straightforward thing to calculate, but it's not," she said, primarily because different states collect and report that data in different ways.

The report, published Tuesday, estimates that in 2010, 45,260 of the 138,532 births in Pennsylvania, or 32.7 percent, were to mothers receiving help from Medicaid.

That puts Pennsylvania on the lower end of the spectrum. The states with the highest Medicaid birth rates are Arkansas, Mississippi, Louisiana and Maine, as well as Washington, D.C.

While the 2010 Affordable Care Act will drive the expansion of Medicaid eligibility in some states (but not Pennsylvania) next year, Ms. Pellegrini said that expansion shouldn't result in more births being paid for by the program. That's because all states, prior to the enactment of the Affordable Care Act, had already expanded eligibility for pregnant women.

While the ACA would expand Medicaid eligibility to at least 133 percent of the federal poverty line among the states that accept federal money to pay for the extension, states already accept pregnant women into the Medicaid program if they make up to 185 percent of the poverty line.

And some states go beyond that threshold.

Where the Medicaid expansion under the ACA will help women of child-bearing age is before and after pregnancies -- women who do not qualify for Medicaid under its usual financial eligibility requirements, but are added to the program because they are pregnant, are dismissed from Medicaid 60 days after giving birth.

Those dismissals will be mitigated somewhat in the states that expand Medicaid eligibility, allowing women to keep their health care coverage longer.

The study was published in the most recent edition of Women's Health Issues, a publication of The Jacobs Institute of Women's Health at GWU.

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Bill Toland: or 412-263-2625.


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