Medicaid coverage before pregnancy: Pregnancy Risk Assessment and Monitoring System (PRAMS).

Access to healthcare, especially for women of reproductive age, is important to preconception, pregnancy, and postpartum care and ultimately to the well-being of women and their families. In this issue, we highlight data from the Pregnancy Risk Assessment and Monitoring System (PRAMS) regarding low-income women's access to Medicaid before becoming pregnant. From 1997 through 2006, the data showed considerable variation across the United States in the prevalence of Medicaid coverage before pregnancy among women with recent live births. Overall, approximately 15% of U.S. women participating in PRAMS reported coverage with Medicaid before pregnancy during 2006. State and local percentages ranged from 5% in Utah to 28% in New York City. Research is needed to understand how health insurance coverage affects access to preconception, prenatal, and postnatal services for reproductive-age women, especially low-income women. Research also is needed to identify how PRAMS data can be used to guide programs and policies intended to reduce adverse outcomes for mothers and infants.