FLORIDA MEDICAID: Expansion Led to Better Maternal Care

      Florida's extension of Medicaid eligibility in July 1989 from 100% to 150% of the poverty level resulted in a 47% jump in births in the state financed by Medicaid -- from 47,400 births in 1988 to 69,600 in 1991. A new study, published in the May/June issue of the Alan Guttmacher Institute's Family Planning Perspectives, analyzed data from all births in Florida between July 1988 and July 1989, as well as calendar year 1991, to assess the eligibility expansion's effect on access to prenatal care and delivery services among eligible women. Using data from state birth certificates, hospital discharge abstracts, Medicaid claims and county health department encounter records, the study noted the following:

• In just 2.5 years, the proportion of deliveries funded by Medicaid rose from 25% to 36%.
• Of the 22,000 additional births covered by Medicaid, 16,000 (73%) were to women made newly eligible by the expansion.
• As the portion of births covered by private insurers remained stable, researchers concluded that the Medicaid expansion did not to produce a "crowd out" effect.
• The number of prenatal care visits by women on Medicaid rose 263,000 after the expansion. Of these new visits, 256,000 took place at county health departments. In total, county health departments accounted for 59% of Medicaid prenatal care in 1991 -- up from 38% in 1989.
• Medicaid payments for pregnancy-related care increased 39%, from $135 million to $187 million -- indicating a 140% increase related to the eligibility expansions.