Left Behind: Medicaid Immigrant Exclusions and Access to Maternal Health Care Across the Reproductive-Perinatal Continuum

Ashley Fox, Frances M. Howell, Ellerie Weber, Teresa Janevic

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Noncitizen immigrants are often excluded from accessing critical safety-net programs, such as Medicaid. Access to health care plays a central role in current policy debates on maternal health. Yet, immigrant exclusions are rarely considered in maternal health policy research. Through open-ended interviews with 31 policymakers, researchers, and program administrators, we examined state variations in approaches to providing care for pregnant, post, and intrapartum immigrant women. We found four themes: (a) a patchwork safety-net exists that provides some access to immigrants ineligible for Medicaid; (b) patchwork coverage leads to patchwork care, which can contribute to maternal health inequities; (c) immigrant Medicaid policy is assembled along a hierarchy of deservingness based on documentation status; (d) Trump-era public charge rules and political climate may have a substantial chilling effect on benefit uptake regardless of eligibility. We discuss implications for efforts to expand Medicaid postpartum and address the maternal health crisis.

Original languageEnglish
Pages (from-to)582-595
Number of pages14
JournalMedical Care Research and Review
Volume80
Issue number6
DOIs
StatePublished - Dec 2023

Keywords

  • Medicaid
  • immigrant
  • maternal and child health
  • state policy

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