This week, I am reading a study finding that a temporary increase in Medicaid reimbursement rates for primary care in 2013-2014 increased utilization of prenatal care among expectant mothers, particularly among non-Hispanic Black/African American women. 

The Maternal and Child Health Journal’s Effect of the Medicaid Primary Care Rate Increase on Prenatal Care Utilization Among Medicaid-Insured Women

The study from researchers from Weill Cornell Medical College’s Department of Healthcare Policy and Research and Georgia State University’s Department of Economics examined data from the 2010-2014 National Vital Statistics System to study the effect of the temporary Medicaid fee bump for primary care, which was enacted as part of the Affordable Care Act, on prenatal care utilization. (Thirteen states were excluded from the analysis due to data limitations.)

What it finds:

• Results indicate the primary care rate increase improved prenatal care utilization for non-Hispanic Black and White women.
• Non-Hispanic Black women giving births in states with larger payment increases had 9% higher odds of initiating prenatal care in the first trimester during the period the increase was available, in comparison to states with smaller rate increases.
• Prenatal care visits also increased significantly for Non-Hispanic Black women and non-Hispanic White women. 
• The study found that the fee increase had no significant impact among Hispanics or non-Hispanic women of other races.

Why it matters:

• The Medicaid primary care rate increase improved prenatal care utilization for some women, especially non-Hispanic Black/African American women.
• Policymakers at both the federal and state levels should consider reinstating the primary care rate increase to improve access to prenatal care for low-income expectant mothers. Some states have maintained the rate increase and other states could do the same. See 2017 Urban Institute report here.