Table 4. Unadjusted and Adjusted Changes in Birth Outcomes Associated With Medicaid Expansion Among Medicaid-Covered Births and Medicaid-Covered Births to Women With at Most a High School Degreea,b.
| Medicaid-Covered Births | Medicaid-Covered Births to Women With at Most a High School Degree | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Difference-in-Differencesc | Difference-in-Difference-in-Differencesc | Difference-in-Differencesc | Difference-in-Difference-in-Differencesc | |||||||||
| Percentage Points | P Value | Percentage Points | P Value | Percentage Points | P Value | Percentage Points | P Value | |||||
| Unadjusted (95% CI) |
Adjusted (95% CI) |
Unadjusted (95% CI) |
Adjusted (95% CI) |
Unadjusted (95% CI) |
Adjusted (95% CI) |
Unadjusted (95% CI) |
Adjusted (95% CI) |
|||||
| Overall | ||||||||||||
| No. | 6 660 476 | 1 721 283 | ||||||||||
| Preterm | −0.19 (−0.27 to −0.11) | −0.06 (−0.24 to 0.11) | .49 | −0.17 (−0.35 to 0.00) | −0.14 (−0.37 to 0.09) | .25 | ||||||
| Very preterm | −0.08 (−0.11 to −0.05) | −0.05d (−0.11 to 0.02) | .17 | −0.04 (−0.11 to 0.03) | −0.01d (−0.08 to 0.06) | .77 | ||||||
| Low birth weight | −0.33 (−0.41 to −0.25) | −0.12 (−0.29 to 0.04) | .15 | −0.38 (−0.54 to −0.22) | −0.26 (−0.44 to −0.08) | .008 | ||||||
| Very low birth weight | −0.08 (−0.11 to −0.05) | −0.04 (−0.10 to 0.01) | .11 | −0.02 (−0.09 to 0.04) | 0.01d (−0.05 to 0.07) | .87 | ||||||
| Non-Hispanic White Infants | ||||||||||||
| No. | 2 468 731 | 465 678 | ||||||||||
| Preterm | −0.12 (−0.25 to 0.01) | −0.02 (−0.22 to 0.17) | 0.82 | −0.26 (−0.60 to 0.07) | −0.08 (−0.46 to 0.30) | .68 | ||||||
| Very preterm | −0.02 (−0.07 to 0.02) | −0.03 (−0.09 to 0.02) | 0.26 | 0.05 (−0.07 to 0.17) | 0.06 (−0.03 to 0.14) | .21 | ||||||
| Low birth weight | −0.13 (−0.25 to −0.01) | −0.02d (−0.20 to 0.15) | 0.79 | −0.27 (−0.59 to 0.04) | −0.10 (−0.45 to 0.25) | .58 | ||||||
| Very low birth weight | −0.03 (−0.08 to 0.01) | −0.05d (−0.09 to −0.01) | 0.03 | 0.05 (−0.07 to 0.16) | 0.02 (−0.07 to 0.12) | .62 | ||||||
| Non-Hispanic Black Infants | ||||||||||||
| No. | 1 449 904 | 3 918 635 | 300 190 | 765 868 | ||||||||
| Preterm | −0.84 (−1.04 to −0.63) | −0.34 (−0.72 to 0.04) | .09 | −0.71 (−0.96 to −0.47) | −0.47 (−0.81 to −0.12) | .01 | −1.30 (−1.78 to −0.82) | −0.51 (−1.03 to 0.02) | .07 | −1.03 (−1.62 to −0.45) | −0.46 (−1.02 to 0.10) | .12 |
| Very preterm | −0.22 (−0.31 to −0.13) | −0.21d (−0.37 to −0.04) | .02 | −0.20 (−0.30 to −0.09) | −0.20 (−0.36 to −0.03) | .03 | −0.39 (−0.60 to −0.17) | −0.32d (−0.56 to −0.09) | .01 | −0.44 (−0.69 to −0.19) | −0.38 (−0.62 to −0.13) | .005 |
| Low birth weight | −0.94 (−1.14 to −0.74) | −0.53 (−0.88 to −0.17) | .01 | −0.81 (−1.05 to −0.57) | −0.68 (−1.16 to −0.21) | .008 | −1.69 (−2.16 to −1.22) | −1.09 (−1.57 to −0.61) | <.001 | −1.41 (−1.98 to −0.85) | −1.01 (−1.55 to −0.47) | .001 |
| Very low birth weight | −0.20 (−0.29 to −0.11) | −0.19d (−0.33 to −0.05) | .01 | −0.16 (−0.26 to −0.07) | −0.16 (−0.32 to 0.00) | .05 | −0.38 (−0.59 to −0.17) | −0.33d (−0.57 to −0.10) | .01 | −0.43 (−0.66 to −0.19) | −0.36 (−0.60 to −0.13) | .004 |
| Hispanic Infants | ||||||||||||
| No. | 2 355 722 | 4 824 453 | 841 868 | 1 307 546 | ||||||||
| Preterm | 0.34 (0.20 to 0.48) | −0.02 (−0.20 to 0.17) | .86 | 0.46 (0.27 to 0.65) | 0.13d (−0.07 to 0.34) | .20 | 0.39 (0.14 to 0.64) | −0.07d (−0.29 to 0.16) | .57 | 0.66 (0.24 to 1.07) | 0.14d (−0.31 to 0.60) | .54 |
| Very preterm | 0.03 (−0.02 to 0.08) | −0.04 (−0.10 to 0.02) | .22 | 0.06 (−0.01 to 0.12) | 0.02d (−0.08 to 0.13) | .66 | 0.07 (−0.02 to 0.17) | 0.01 (−0.06 to 0.08) | .79 | 0.02 (−0.13 to 0.17) | −0.03d (−0.19 to 0.12) | .68 |
| Low birth weight | 0.28 (0.16 to 0.40) | 0.01d (−0.17 to 0.20) | .90 | 0.41 (0.23 to 0.58) | 0.11d (−0.13 to 0.35) | .38 | 0.26 (0.05 to 0.47) | 0.01d (−0.32 to 0.35) | .94 | 0.53 (0.16 to 0.91) | 0.15d (−0.39 to 0.69) | .58 |
| Very low birth weight | 0.01 (−0.03 to 0.06) | −0.02 (−0.09 to 0.04) | .45 | 0.05 (−0.01 to 0.11) | 0.02d (−0.06 to 0.10) | .57 | 0.10 (0.02 to 0.19) | 0.07 (0.01 to 0.13) | .03 | 0.06 (−0.08 to 0.19) | 0.02d (−0.12 to 0.16) | .77 |
Birth outcomes included preterm birth (<37 weeks’ gestation), very preterm birth (<32 weeks’ gestation), low birth weight (<2500 g), and very low birth weight (<1500 g).
Medicaid expansion and nonexpansion states are listed in footnote “b” of Table 1.
Coefficients were calculated using linear regression models with estimates multiplied by 100 to provide percentage point differences. Adjusted difference-in-differences and adjusted difference-in-difference-in-differences regressions were adjusted for all state-level and individual-level characteristics outlined in Tables 1 and 2 as well as for state-level dummy variables with standard errors clustered at the state level. As the difference-in-difference-in-differences analyses compare minority infants with white infants there are no difference-in-difference-in-differences estimates for the overall group or for the white infant category.
Indicates outcome in adjusted difference-in-differences or difference-in-difference-in-differences regression that does not pass the parallel trends test.