Medicaid and Preterm Birth and Low Birth Weight: The Last Two Decades

Objectives: To determine if (1) birth outcomes among women on Medicaid differ significantly from outcomes of those with private insurance, after controlling for known risk factors, and (2) enhanced prenatal care influences care use and birth outcomes. Methods: This is a review of studies published between 1989 and 2009 that examined birth outcomes (1) between women on Medicaid and those with private insurance and (2) among Medicaid enrollees who received comprehensive prenatal care. Results: When corrected for risk variables, birth outcomes are not different between private insurance and Medicaid patients. The impact of comprehensive prenatal care programs on birth outcomes varies across states and regions. Conclusions: There is a need for critical evaluation of comprehensive programs in a regional and state context to determine opportunities for improvement.