Research Update: Medicaid Expansion Associated with Decrease in Cases of Reported Child Neglect

This week, I am highlighting a study suggesting that Medicaid expansion was associated with reductions in number of reported cases of child neglect. This study builds on prior research finding that Medicaid expansion is associated with greater parental financial stability and access to mental health care. In this study, researchers compared reported cases of child neglect and child physical abuse in expansion and non-expansion states.  

The Journal of American Medical Associations’ Network Open Journal’s  Assessment of Rates of Child Maltreatment in States With Medicaid Expansion vs States Without Medicaid Expansion

The study from researchers from University of Washington School of Medicine and School of Public Health, Seattle in collaboration with the Seattle Children’s Research Institute, Center for Child Health, Behavior and Development examined data from the National Child Abuse and Neglect Data System (NCANDS) Child Files over the period of 2010 to 2016.  The study examined cases of child neglect and physical abuse among children younger than 6 years old (but excluded cases of reported sexual and emotional abuse). Data were analyzed for 31 states and the District of Columbia that expanded Medicaid and 19 states that did not. (States that expanded Medicaid after January 1, 2014 are included in the comparison only for the time period after they had implemented the expansion.)  According to the researchers, child neglect accounts for ¾ of all reported child abuse cases in the United States. 

What it finds:

  • Medicaid coverage for adults with a dependent child increased by 4.2 percent in the median expansion state between 2013 and 2016, compared to 1.9 percent in the median non-expansion state. 
  • Results indicate that after Medicaid expansion there were 422 fewer cases of neglect per 100,000 in expansion states (comparing pre- and post-expansion periods) versus in non-expansion states.  (There, however, was no association found in reported cases of physical abuse. Also, adult individuals with Medicaid coverage did not have different rates of reported child neglect cases than those with other sources of coverage.)

Why it matters:

  • State’s Medicaid expansion status was associated with a reduction in the reported child neglect rate. 
  • These findings suggest that expanding Medicaid can potentially help prevent cases of child neglect, yet another benefit if more states take up the Medicaid expansion.
Lauren Roygardner
Lauren Roygardner is a Senior Research Associate at the Georgetown University McCourt School of Public Policy’s Center for Children and Families.

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