February 5, 1997

Babies Are ComingDon't Cap Medicaid

Author Affiliations

From the Department of Health Policy and Management, Harvard School of Public Health, Boston, Mass.

JAMA. 1997;277(5):421. doi:10.1001/jama.1997.03540290073035

Congress and the White House are beginning new budget negotiations with a strong push to cap federal Medicaid expenditures. Simultaneously, there is bipartisan consensus that providing health care for children, especially young children, is a high national priority. The 2 objectives are in conflict. The rhetoric on limiting Medicaid expenditures ignores both the role Medicaid has today in paying for births and the greater need for this program in the future.

In 1994, there were 12 states in which Medicaid paid for 45% or more of all births.1 Nationally in that year, Medicaid paid for 39% of all births. The 39% figure is up from 32% in 1991, a time when the late 1980s' Medicaid eligibility expansions for pregnant women had become largely implemented.2

For the past 5 years, the rising percentage of Medicaid births reflects a stable number of Medicaid births and a declining number of births