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Medicaid and newborn care: challenges and opportunities

Journal of Perinatology volume 43, pages 1072–1078 (2023)Cite this article

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Abstract

Since its creation in 1965, Medicaid has operated as a federal-state partnership that provides a robust set of medical benefits to low-income families, including pregnant people and infants. In many ways, Medicaid has met its initial promise. However, medical benefits, provider payments, and key administrative procedures regarding eligibility, enrollment, and access to care vary substantially among state Medicaid programs. These variations have created profound inequities across states in the care of parents and children, particularly during pregnancy and in the postpartum and neonatal periods. Here we review select aspects of the Medicaid program pertinent to newborns and infants that contribute to eligibility and enrollment gaps, variations in benefits coverage and payment rates, and racial disparities in both access to healthcare and infant health outcomes. We outline a number of structural reforms of the Medicaid program that can improve newborn and infant access to care and outcomes and redress existing inequities.

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Fig. 1: Percent of infants younger than one year of age in Medicaid/Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) who had an enrollment gap during the first year of life, by state, federal fiscal year 2018.

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Author information

Authors and Affiliations

  1. Division of Neonatology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Emily R. Miller

  2. Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA

    Emily R. Miller

  3. Department of Pediatrics, Division of Neonatology, University of Florida College of Medicine - Jacksonville, Jacksonville, FL, USA

    Mark L. Hudak

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  1. Emily R. Miller
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EM wrote the initial draft of the manuscript, made revisions based on reviewers’ suggestions, and created the figure. MH reviewed several drafts of the manuscript and made critical revisions, and created the table.

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Correspondence to Emily R. Miller.

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Miller, E.R., Hudak, M.L. Medicaid and newborn care: challenges and opportunities. J Perinatol 43, 1072–1078 (2023). https://doi.org/10.1038/s41372-023-01714-4

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