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IMI’s Dr. Moore Co-Authors Article in JAMA on Medicaid Expansion and Preterm Birth

April 23, 2019

IMI’s Dr. Moore Co-Authors Article in JAMA on Medicaid Expansion and Preterm Birth


The Journal of the American Medical Association (JAMA) announced today the publication of the article, “Association of State Medicaid Expansion Status with Low Birth Weight and Preterm Birth.” The piece, co-authored by founding executive director for the Institute for Medicaid Innovation, Jennifer E. Moore, PhD, RN, examines the effects of Medicaid expansion through the Affordable Care Act on key birth outcomes such as preterm birth and birth weight. Through Medicaid expansion, researchers found greater reductions in the rates of low birth weight and preterm births with black infants, while infants of other races and ethnicities demonstrated no statistically significant changes in these measures.

The authors conducted an observational study using data from 15.6 million births from 2011-2016. The data represented 18 states that had expanded Medicaid and 17 states that had not expanded. Looking at the data through the lens of race and ethnicity, the study found that black infants born to mothers with at most a high school degree, had an 8% decline in low birth weight babies in Medicaid expansion states. This contrasts with a 4.5% increase in low birth in non-expansion states. A similar pattern was observed in very low birth weight outcomes for black infants, as well: in states with Medicaid expansion, there was a 15% decline in very low birth weights, but there was a 2% increase in the states that had not expanded Medicaid. Through Medicaid expansion, researchers see a notable decline in disparities in birth outcomes for blank infants.

 Dr. Moore noted, "considering the national attention on maternal mortality and the discussion about the role of racism in explaining the high rates of maternal deaths, this study provides additional information about the role of poverty and race on birth outcomes specific to the Medicaid population.  It also highlights the important role of access and coverage to care through Medicaid expansion for pregnant women in the U.S.”

In addition to Dr. Moore, authors for this article include Clare C. Brown, PhD, MPH, Holly C. Felix, PhD, MPAM. Kathryn Stewart, MD, MPH, T. Mac Bird, PhD, MS,  Curtis L. Lowery, MD , and J. Mick Tilford, PhD; all affiliated with the University of Arkansas.  The full article can be accessed here.  JAMA has also written a special editor’s note on the article that can be found here.


About the IMI

The Institute for Medicaid Innovation (IMI) is a 501(c)3 nonprofit, nonpartisan research organization that provides independent, nonpartisan information and analysis that informs Medicaid policy and improves the health of the nation.


Media contact:

Lydia Tonkonow