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The Long-Term Effects of Early Life Medicaid Coverage


Although the link between the fetal environment and later life health and achievement is well-
established, few studies have evaluated the extent to which public policies aimed at improving
fetal health can generate benefits that persist into adulthood. In this study, we evaluate how a
rapid expansion of public health insurance for pregnant women and infants under the Medicaid
program affected the adult outcomes of individuals born between 1979 and 1993 who gained
access to coverage in utero and during the first year of life. We conduct this analysis by
exploiting state- and cohort-level variation in the timing and generosity of Medicaid expansions
using a simulated eligibility instrumental variables model. We find that cohorts whose mothers
gained eligibility for prenatal coverage under Medicaid have lower rates of chronic conditions as
adults and experience fewer hospitalizations related to diabetes and obesity. We also find that the
prenatal expansions increased high school graduation rates among affected cohorts. Our results
indicate that expanding Medicaid prenatal coverage had sizeable long-term benefits for the next


Source: University of Michigan (2017). The Long-Term Effects of Early life Medicaid Coverage.