Poster #25 - Deeper than race: Impact of Medicaid/CHIP expansions on Black immigrant maternal and birth outcomes

• In Event: Friday Poster Reception

Abstract

Black mothers and babies face higher rates of pregnancy-related deaths and health complications than their White counterparts, and these disparities are growing. Research shows that Medicaid expansion is associated with lower rates of maternal mortality and improved birth outcomes. Little is known, however, about the effects of expansion on Black immigrants, who are largely understudied relevant to other immigrant groups. It is important to examine whether expansion policies that eliminate exclusions from Medicaid and CHIP eligibility based on immigration status may improve health care access and support healthy outcomes for Black immigrant mothers and babies. This paper will investigate the effects of the 2009 Children’s Health Insurance Program Reauthorization Act (CHIPRA) on maternal and birth outcomes among foreign-born Black women and their infants. This will be the first known study to estimate the effects of this policy on this population. It will address the following primary research question: How do Medicaid/CHIP eligibility expansions under CHIPRA impact maternal mortality, prenatal care use, insurance coverage, and birth outcomes for Black immigrant women? Using a difference-in-differences research design with staggered treatment adoption and birth and mortality data from the National Center for Health Statistics, I will compare changes in outcomes over time among Black immigrant women living in expansion states relative to those living in non-expansion states. I was recently granted access to the restricted-use NCHS data, which has expanded the scope of this research and will take more time to analyze. The NCHS data do not include information about state CHIPRA adoption. To address this gap, I have created a state-by-year policy dataset by consolidating information from various government and policy organizations (e.g., Medicaid.gov, Kaiser Family Foundation) to identify which states adopted CHIPRA and in what year. The findings are expected to show that Medicaid/CHIP expansions are associated with higher rates of insurance coverage and greater prenatal care use among a high-risk subgroup of Black immigrant mothers, while also highlighting disparities based on their region of origin. The relevance of this research is particularly urgent today, as government leaders propose significant cuts to Medicaid and other safety net programs that are important to the health and well-being of Black families. If findings show that CHIPRA positively affects Black immigrant mothers and babies, it might provide compelling evidence for state policymakers to lift health coverage restrictions for immigrants, especially in states that have not. Moreover, this research has the potential to foster collaborations among policymakers, practitioners, and community advocates who are focused on addressing the Black maternal health crisis. The importance of fostering partnerships with community organizations that empower Black immigrant communities and connect them to critical services will be discussed.

Author

• Menna Mburi, University of North Carolina at Chapel Hill
  Presenting Author