Want to Reduce your State’s Infant Mortality Rate? Try Expanding Medicaid

Evidence continues to build on the benefits of the ACA’s Medicaid expansion for adults: improving health coverage and access, promoting family economic security, and creating peace of mind for the whole family (including, and especially, children).

And here’s another study for the maternal and child health community: A new study published online last week in the American Journal of Public Health found that states expanding Medicaid saw greater declines in their infant mortality rates between 2010 and 2016. While infant mortality rates declined in both Medicaid expansion and non-Medicaid expansion states alike, achieving the Healthy People 2020 objective of a 10% decrease in the national rate, Medicaid expansion states reduced infant mortality rates more than 50% greater than non-Medicaid expansion states.

The study also showed potential for expansion in reducing health disparities in this area. Between 2010 and 2015, states that expanded Medicaid saw more than double the decline in African American infant mortality rates compared to non-expansion states.

While the authors indicate a need to unpack the exact elements of the Medicaid expansion that may play a role here (e.g. prenatal care use, poverty levels, etc.), they argue that the expansion likely contributed to these faster declines since we know coverage itself can improve birth outcomes for low-income women. (Side note: Since this looked at Medicaid expansion in a world that didn’t allow for lots of red tape barriers to coverage such as those we are seeing proposed now—work requirements, lockouts, time limits—I would imagine that these new eligibility conditions would dampen the positive effects this study identified since they would mean fewer people actually accessing coverage…)

Many know well that infant mortality rates in many states not only exceed the U.S. average but are also higher than other developed nations. States eager to improve these rates —including addressing health disparities among African American families — could start by accepting federal funding to extend Medicaid to more of their residents.  

Elisabeth Wright Burak is a Senior Fellow at the Georgetown University McCourt School of Public Policy’s Center for Children and Families.