THE EFFECTS OF FLORIDA MEDICAID ELIGIBILITY EXPANSION FOR PREGNANT-WOMEN

Objectives. This is a study of the effects on prenatal care and birth outcomes of Florida's July 1989 expansion in the Medicaid income eligi bility threshold for pregnant women. Methods. Concurrent and longitudi nal comparisons were performed with matched birth and death certificat es, hospital discharge data, Medicaid eligibility records, and records from county health departments for women giving birth from July 1988 to June 1989 (n = 56 101) or in calendar year 1991 (n = 78 421). Measu res included amount and timing of prenatal care and rates of low birth weight and infant deaths. Results. The Medicaid expansion led to great er access and improved birth outcomes. For example, the rate of low-bi rthweight infants among low-income women without private insurance fel l from 67.9 to 61.8 per 1000, while it remained unchanged for low-inco me women with private insurance. Women in the expansion group who used county health departments had fewer low-birthweight infants than thos e using other delivery systems. Conclusions. The benefits from the Flo rida expansion appear to be greater than those reported for other stat es. The role of the public health delivery system may account for some of Florida's success.