Abstract
Background
Methods
Findings
Conclusions/Implications for Research and Policy
Introduction and Background
National Governors’ Association (NGA). (2011). 2010 Maternal and child health update: States makes progress towards improving systems of care. Retrieved from http://www.nga.org/files/live/sites/NGA/files/pdf/MCHUPDATE2010.PDF.
Kaiser Commission on Medicaid and the Uninsured. (2012), Where are states today: Medicaid and CHIP eligibility levels for children and non-disabled adults. Retrieved from http://www.kff.org/medicaid/upload/7993-02.pdf.
Guttmacher Institute. (2013). State data center. Retrieved from http://www.guttmacher.org/datacenter/servlet/CreateTable?action=doTable; http://www.guttmacher.org/media/inthenews/2010/09/17/index.html.
Pellegrini, C., & Garro, N. (2013). Medicaid expansion: Benefits for women of childbearing age and their children. Retrieved from: http://healthaffairs.org/blog/2013/02/22/medicaid-expansion-benefits-for-women-of-childbearing-age-and-their-children/.
National Governors Association (NGA). (2010). Maternal and child health update: States make progress towards improving systems of care. Issue Brief [see Table 6]. Retrieved from: http://www.nga.org/files/live/sites/NGA/files/pdf/MCHUPDATE2010.PDF.
National Governors Association (NGA). (2010). Maternal and child health update: States make progress towards improving systems of care. Issue Brief [see Table 6]. Retrieved from: http://www.nga.org/files/live/sites/NGA/files/pdf/MCHUPDATE2010.PDF.
National Governors’ Association (NGA). (2011). 2010 Maternal and child health update: States makes progress towards improving systems of care. Retrieved from http://www.nga.org/files/live/sites/NGA/files/pdf/MCHUPDATE2010.PDF.
Methods
State | Revised Birth Certificate | Source of Birth Data |
---|---|---|
Alabama | No | Vital Records |
Alaska | No | Vital Records and Medicaid |
Arizona | No | Vital Records |
Arkansas | No | Medicaid |
California | Yes | Vital Records |
Colorado | Yes | Vital Records |
Connecticut | No | Vital Records and Medicaid |
Delaware | Yes | Vital Records |
District of Columbia | Yes | Medicaid |
Florida | Yes | Vital Records |
Georgia | Yes | Vital Records |
Hawaii | No | HCUP |
Idaho | Yes | Vital Records |
Illinois | Yes | Medicaid |
Indiana | Yes | Vital Records |
Iowa | Yes | Vital Records and Medicaid |
Kansas | Yes | Vital Records |
Kentucky | Yes | Vital Records |
Louisiana | No | Medicaid |
Maine | No | Medicaid |
Maryland | Yes | Vital Records |
Massachusetts | No | Vital Records |
Michigan | Yes | Vital Records |
Minnesota | No | Vital Records and Medicaid |
Mississippi | No | Medicaid |
Missouri | Yes | Vital Records |
Montana | Yes | Vital Records |
Nebraska | Yes | Vital Records |
Nevada | Yes | Medicaid |
New Hampshire | Yes | Vital Records |
New Jersey | No | Vital Records |
New Mexico | Yes | HCUP |
New York | Yes | Vital Records |
North Carolina | No | Vital Records and Medicaid |
North Dakota | Yes | Vital Records |
Ohio | Yes | Vital Records |
Oklahoma | Yes | Medicaid |
Oregon | Yes | Vital Records |
Pennsylvania | Yes | Vital Records |
Puerto Rico | No | Medicaid |
Rhode Island | No | Vital Records |
South Carolina | Yes | Vital Records |
South Dakota | Yes | Vital Records |
Tennessee | Yes | Vital Records |
Texas | Yes | HCUP |
Utah | Yes | Vital Records |
Vermont | Yes | Vital Records |
Virginia | No | Vital Records |
Washington | Yes | Vital Records |
West Virginia | No | Vital Records |
Wisconsin | No | Vital Records and Medicaid |
Wyoming | Yes | Vital Records |
Results
State-Based Medicaid Birth Estimates
State | 2008 Total Births | 2008 Medicaid Births | 2008 % Medicaid Births | 2009 Total Births | 2009 Medicaid Births | 2009 % Medicaid Births | 2010 Total Births | 2010 Medicaid Births | 2010 % Medicaid Births |
---|---|---|---|---|---|---|---|---|---|
Alabama | 64,345 | 31,106 | 48.34 | 62,476 | 30,980 | 49.59 | 59,979 | 31,498 | 52.52 |
Alaska | 11,469 | 5,743 | 50.07 | 11,342 | 5,916 | 52.16 | 11,502 | 6,053 | 52.63 |
Arizona | 99,215 | 52,081 | 52.49 | 92,616 | 49,538 | 53.49 | 87,053 | 46,393 | 53.29 |
Arkansas | 40,662 | 25,928 | 63.76 | 39,686 | 25,337 | 63.84 | 38,224 | 25,659 | 67.13 |
California | 551,567 | 260,195 | 47.17 | 526,774 | 248,705 | 47.21 | 509,797 | 242,732 | 47.60 |
Colorado | 70,029 | 24,007 | 34.28 | 68,607 | 24,911 | 36.31 | 66,349 | 24,431 | 36.82 |
Connecticut | 40,388 | 11,393 | 28.21 | 38,876 | 11,700 | 30.10 | 37,448 | 11,770 | 31.43 |
Delaware | 12,016 | 5,740 | 47.77 | 11,369 | 5,529 | 48.63 | |||
District of Columbia, | 9,134 | 9,008 | 6,446 | 71.56 | 9,156 | 6,218 | 67.91 | ||
Florida | 231,417 | 102,339 | 44.22 | 221,391 | 105,257 | 47.54 | 214,519 | 104,721 | 48.82 |
Georgia | 146,414 | 55,053 | 37.60 | 141,332 | 57,416 | 40.62 | 133,668 | 56,009 | 41.90 |
Hawaii | 19,462 | 4,459 | 22.91 | 18,891 | 4,707 | 24.92 | 18,933 | 4,551 | 24.04 |
Idaho | 25,156 | 8,155 | 32.42 | 23,726 | 8,744 | 36.85 | 23,202 | 8,954 | 38.59 |
Illinois | 176,634 | 89,800 | 50.84 | 171,077 | 88,722 | 51.86 | 165,200 | 85,978 | 52.04 |
Indiana | 88,679 | 38,842 | 43.80 | 86,126 | 39,270 | 45.60 | 83,867 | 39,071 | 46.59 |
Iowa | 40,221 | 15,297 | 38.03 | 39,662 | 15,732 | 39.67 | 38,514 | 15,582 | 40.46 |
Kansas | 41,815 | 10,689 | 25.56 | 41,388 | 11,225 | 27.12 | 40,439 | 13,159 | 32.54 |
Kentucky | 56,901 | 25,756 | 45.26 | 55,929 | 24,584 | 43.96 | 54,128 | 23,594 | 43.59 |
Louisiana | 65,063 | 45,339 | 69.68 | 65,109 | 45,076 | 69.23 | 62,555 | 43,175 | 69.02 |
Maine | 13,605 | 6833 | 50.22 | 13,466 | 7103 | 52.75 | 12,950 | 8164 | 63.04 |
Maryland | 77,268 | 45,019 | 58.26 | 74,999 | 43,281 | 57.71 | 73,783 | 19,132 | 25.93 |
Massachusetts | 76,969 | 19,469 | 25.29 | 74,966 | 19,666 | 26.23 | 72,835 | 19,485 | 26.75 |
Michigan | 121,231 | 52,226 | 43.08 | 117,309 | 51,620 | 44.00 | 114,717 | 51,944 | 45.28 |
Minnesota | 72,382 | 27,897 | 38.54 | 70,617 | 30,521 | 43.22 | 68,407 | 29,983 | 43.83 |
Mississippi | 44,904 | 27,994 | 62.34 | 42,809 | 27,600 | 64.47 | 39,984 | 25,864 | 64.69 |
Missouri | 80,944 | 38,004 | 46.95 | 78,849 | 37,675 | 47.78 | 76,718 | 32,411 | 42.25 |
Montana | 12,595 | 3,795 | 30.13 | 12,280 | 3,985 | 32.45 | 12,058 | 4,225 | 35.04 |
Nebraska | 26,992 | 10,049 | 37.23 | 26,931 | 10,038 | 37.27 | 25,916 | 8,070 | 31.14 |
Nevada | 39,474 | 14,801 | 37.50 | 37,523 | 14,446 | 38.50 | 35,724 | 15,737 | 44.05 |
New Hampshire | 13,684 | 3,839 | 28.05 | 13,389 | 3,865 | 28.87 | 12,873 | 3,845 | 29.87 |
New Jersey | 112,428 | 26,904 | 23.93 | 109,543 | 26,748 | 24.42 | 101,409 | 28,499 | 28.10 |
New Mexico | 30,156 | 16,518 | 54.78 | 28,873 | 16,034 | 55.53 | 27,795 | 14,832 | 53.36 |
New York | 249,655 | 111,282 | 44.57 | 246,592 | 112,814 | 45.75 | 242,914 | 111,144 | 45.75 |
North Carolina | 130,758 | 68,838 | 52.65 | 126,785 | 68,186 | 53.78 | 122,302 | 65,775 | 53.78 |
North Dakota | 8,931 | 2,539 | 28.43 | 8,974 | 2,562 | 28.55 | 9,088 | 2,594 | 28.54 |
Ohio | 148,592 | 55,859 | 37.59 | 144,569 | 55,957 | 38.71 | 139,034 | 53,140 | 38.22 |
Oklahoma | 53,733 | 32,601 | 60.67 | 52,729 | 33,898 | 64.29 | 51,798 | 33,125 | 63.95 |
Oregon | 49,117 | 19,993 | 40.70 | 47,188 | 19,865 | 42.10 | 45,596 | 20,463 | 44.88 |
Pennsylvania | 139,830 | 43,642 | 31.21 | 139,653 | 46,034 | 32.96 | 138,532 | 45,260 | 32.67 |
Puerto Rico | 45,689 | 25,613 | 56.06 | 44,830 | 26,799 | 59.78 | 42,203 | 25,231 | 59.78 |
Rhode Island | 12,031 | 5,495 | 45.67 | 11,421 | 5,321 | 46.59 | 11,166 | 5,142 | 46.05 |
South Carolina | 63,077 | 30,341 | 48.10 | 60,682 | 28,348 | 46.72 | 58,325 | 29,153 | 49.98 |
South Dakota | 12,074 | 4,096 | 33.92 | 11,930 | 4,225 | 35.41 | 11,795 | 4,244 | 35.98 |
Tennessee | 85,480 | 41,784 | 48.88 | 82,109 | 41,413 | 50.44 | 79,345 | 40,703 | 51.30 |
Texas | 412,224 | 181,305 | 43.98 | 408,487 | 191,513 | 46.88 | 392,876 | 187,140 | 47.63 |
Utah, | 55,372 | 13,796 | 24.92 | 53,587 | 15,628 | 29.16 | 51,925 | 15,911 | 30.64 |
Vermont | 6,342 | 2,805 | 44.23 | 6,109 | 2,791 | 45.69 | 6,224 | 2,901 | 46.61 |
Virginia | 106,578 | 28,189 | 26.45 | 104,979 | 28,047 | 26.72 | 102,934 | 30,626 | 29.75 |
Washington | 90,270 | 33,687 | 37.32 | 89,242 | 34,802 | 39.00 | 86,480 | 33,545 | 38.79 |
West Virginia | 21,493 | 9,232 | 42.95 | 21,275 | 9,464 | 44.48 | 20,407 | 10,575 | 51.82 |
Wisconsin | 68,367 | 33,848 | 49.51 | 70,824 | 34,694 | 48.99 | 68,367 | 33,848 | 49.51 |
Wyoming | 8,022 | 2,944 | 36.70 | 7,874 | 2,896 | 36.78 | 7,541 | 2,892 | 38.35 |
Total | 4,280,854 | 1,715,957 | 40.08 | 3,942,972 | 1,730,568 | 43.89 | 3,780,519 | 1,805,151 | 47.75 |

State | % Change 2008–2009 | % Change 2009–2010 | % Change 2008–2010 |
---|---|---|---|
Alabama | 2.59 | 5.91 | 8.65 |
Alaska | 4.17 | 0.90 | 5.11 |
Arizona | 1.91 | −0.37 | 1.52 |
Arkansas | 0.13 | 5.15 | 5.29 |
California | 0.08 | 0.83 | 0.91 |
Colorado | 5.92 | 1.40 | 7.41 |
Connecticut | 6.70 | 4.42 | 11.41 |
Delaware | 1.80 | — | — |
District of Columbia | — | −5.10 | — |
Florida | 7.51 | 2.69 | 10.40 |
Georgia | 8.03 | 3.15 | 11.44 |
Hawaii | 8.77 | −3.53 | 4.93 |
Idaho | 13.66 | 4.72 | 19.03 |
Illinois | 2.01 | 0.35 | 2.37 |
Indiana | 4.11 | 2.17 | 6.37 |
Iowa | 4.31 | 1.99 | 6.39 |
Kansas | 6.10 | 19.99 | 27.31 |
Kentucky | −2.87 | −0.84 | −3.69 |
Louisiana | −0.65 | −0.30 | −0.95 |
Maine | 5.04 | 19.51 | 25.53 |
Maryland | −0.94 | −55.07 | −55.49 |
Massachusetts | 3.72 | 1.99 | 5.78 |
Michigan | 2.14 | 2.91 | 5.11 |
Minnesota | 12.14 | 1.41 | 13.73 |
Mississippi | 3.42 | 0.34 | 3.77 |
Missouri | 1.77 | −11.57 | −10.01 |
Montana | 7.70 | 7.98 | 16.30 |
Nebraska | 0.11 | −16.45 | −16.36 |
Nevada | 2.67 | 15.50 | 17.47 |
New Hampshire | 2.92 | 3.46 | 6.49 |
New Jersey | 2.05 | 15.07 | 17.43 |
New Mexico | 1.37 | −3.91 | −2.59 |
New York | 2.65 | 0.00 | 2.65 |
North Carolina | 2.15 | 0.00 | 2.15 |
North Dakota | 0.42 | −0.04 | 0.39 |
Ohio | 2.98 | −1.27 | 1.68 |
Oklahoma | 5.97 | −0.53 | 5.41 |
Oregon | 3.44 | 6.60 | 10.27 |
Pennsylvania | 5.61 | −0.88 | 4.68 |
Puerto Rico | 6.64 | 0.01 | 6.65 |
Rhode Island | 2.01 | −1.16 | 0.83 |
South Carolina | −2.87 | 6.98 | 3.91 |
South Dakota | 4.39 | 1.61 | 6.07 |
Tennessee | 3.19 | 1.70 | 4.95 |
Texas | 6.59 | 1.60 | 8.30 |
Utah | 17.01 | 5.08 | 22.95 |
Vermont | 3.30 | 2.01 | 5.38 |
Virginia | 1.02 | 11.34 | 12.48 |
Washington | 4.50 | −0.54 | 3.94 |
West Virginia | 3.56 | 16.50 | 20.65 |
Wisconsin | −1.05 | 1.06 | 0.00 |
Wyoming | 0.22 | 4.27 | 4.50 |
Total | 9.49 | 8.79 | 19.12 |
Data Challenges and Limitations
Vital records data
Time lag for reporting
Massachusetts Department of Public Health. (2013). Massachusetts births 2010. Retrieved from http://www.mass.gov/eohhs/docs/dph/research-epi/birth-report-2010.pdf.
Missing/unknown payment source
State | Percent of Unknown Answers | ||
---|---|---|---|
2008 | 2009 | 2010 | |
District of Columbia | — | 24.09 | 9.16 |
Georgia | 23.52 | 14.74 | 11.57 |
Montana | 9.88 | 7.57 | 2.43 |
Ohio | 4.18 | 4.57 | 4.08 |
Tennessee | 3.76 | 4.39 | 5.14 |
West Virginia | 25.88 | 25.32 | 13.58 |
Self-reported data
Different payer questions

Implementation challenges
Medicaid data
Dailard, C. (2002). New SCHIP prenatal care rule advances fetal rights at low-income women's expense. The Guttmacher Report on Public Policy, Vol 5, No. 5, Retrieved from: http://www.guttmacher.org/pubs/tgr/05/5/gr050503.html.
Kaiser Commission on Medicaid and the Uninsured. (2012), Where are states today: Medicaid and CHIP eligibility levels for children and non-disabled adults. Retrieved from http://www.kff.org/medicaid/upload/7993-02.pdf.
Number of newborns versus number of deliveries
Hospital discharge data
Linked datasets for Medicaid births
Discussion
Implications for Practice and/or Policy
Pellegrini, C., & Garro, N. (2013). Medicaid expansion: Benefits for women of childbearing age and their children. Retrieved from: http://healthaffairs.org/blog/2013/02/22/medicaid-expansion-benefits-for-women-of-childbearing-age-and-their-children/.
Agency for Healthcare Research and Quality. (2012). Healthcare Cost and Utilization Project (HCUP), 2012. Available at: http://www.ahrq.gov/research/data/hcup/index.html.
Acknowledgments
References
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Pellegrini, C., & Garro, N. (2013). Medicaid expansion: Benefits for women of childbearing age and their children. Retrieved from: http://healthaffairs.org/blog/2013/02/22/medicaid-expansion-benefits-for-women-of-childbearing-age-and-their-children/.
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- ErratumWomen's Health IssuesVol. 23Issue 6
- PreviewRefers to: “Medicaid Covered Births, 2008 Through 2010, in the Context of the Implementation of Health Reform,” Anne Rossier Markus, JD, PhD, MHS, Ellie Andres, MPH, DrPH-c, Kristina D. West, JD, Nicole Garro, MPH, Cynthia Pellegrini, BA. Women's Health Issues, Volume 23, Issue 5, Pages e273-e280, September 2013.
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