Medicaid expansions and welfare contractions: offsetting effects on prenatal care and infant health?

Most states have adopted administrative measures to encourage the use of prenatal care among medicaid-eligible women. At the same time, declining welfare caseloads have caused many women to lose medicaid. We examine the effects of changes in income eligibility, administrative procedures, and welfare caseloads using data from all birth certificates for 1990-1996. Higher income cutoffs increased use of prenatal care, while decreases in welfare caseloads reduced it. Changes in income cutoffs also reduced fetal deaths. These results suggest that the administrative reforms have not broken the close link between welfare participation and access to medicaid.