Health insurance, the quantity and quality of prenatal care, and infant health.

This paper presents a comprehensive analysis of the relationship between Medicaid, infant health, and the quantity and quality of prenatal care using data from the 1988 National Maternal and Infant Health Survey (NMIHS). This integrated approach provides a more complete picture of the effect of Medicaid and its avenues of influence, and is less likely to lead to spurious findings. The results indicate that there was no statistically significant relationship between insurance status and birth weight holding constant other observed characteristics, although there was some evidence that uninsured women and Medicaid recipients received less prenatal care than did privately insured women. Differences in prenatal care utilization, however, were small. In addition, there was no evidence that uninsured women or Medicaid recipients received lower-quality prenatal care than privately insured women did even in a period prior to implementation of state programs aimed at ensuring high-quality care. The results of this paper raise questions about the efficacy of the current public health response to poor infant health that relies on expanding insurance coverage and enriched prenatal care programs.