To assess the impact of Medicaid expansion for pregnant women in South Caro
lina and California, the authors compared change in rates of timely prenata
l care, adverse infant and maternal health outcomes, and use of cesarean se
ction for groups of pregnant women who were either uninsured or covered by
Medicaid, versus women with private coverage. The results showed small and/
or inconsistent changes. Provision of coverage may be the first logical ste
p in improving health care for the uninsured but outcomes may rely more on
outreach, coordination of care, and non-medical interventions than on Provi
sion of insurance coverage per se.