Division of Neonatology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA.
J Perinatol. 2023 Aug;43(8):1072-1078. doi: 10.1038/s41372-023-01714-4. Epub 2023 Jul 12.
Since its creation in 1965, Medicaid has operated as a federal-state partnership that provides a robust set of medical benefits to low-income families, including pregnant people and infants. In many ways, Medicaid has met its initial promise. However, medical benefits, provider payments, and key administrative procedures regarding eligibility, enrollment, and access to care vary substantially among state Medicaid programs. These variations have created profound inequities across states in the care of parents and children, particularly during pregnancy and in the postpartum and neonatal periods. Here we review select aspects of the Medicaid program pertinent to newborns and infants that contribute to eligibility and enrollment gaps, variations in benefits coverage and payment rates, and racial disparities in both access to healthcare and infant health outcomes. We outline a number of structural reforms of the Medicaid program that can improve newborn and infant access to care and outcomes and redress existing inequities.
自 1965 年成立以来，医疗补助计划一直作为联邦-州合作项目运作，为低收入家庭提供包括孕妇和婴儿在内的一系列广泛的医疗福利。在许多方面，医疗补助计划已经实现了最初的承诺。然而，医疗福利、提供者付款以及有关资格、登记和获得医疗保健的关键行政程序在各州的医疗补助计划中存在很大差异。这些差异在各州造成了父母和儿童护理方面的巨大不平等，特别是在怀孕期间以及产后和新生儿期。在这里，我们回顾了医疗补助计划中与新生儿和婴儿有关的一些方面，这些方面导致了资格和登记差距、福利覆盖范围和付款率的差异，以及在获得医疗保健和婴儿健康结果方面的种族差异。我们概述了医疗补助计划的一些结构性改革，可以改善新生儿和婴儿获得护理和结果的机会，并纠正现有的不平等现象。
