Published February 2013
Prenatal care can help prevent costly complications and problems such as low birth weight or preterm birth. According to the National Business Group on Health, every $1 employers provide for prenatal care yields a savings of $3.33 for medical care after birth. The average medical cost for healthy infants during the first year of life was $3,325 in 2005, compared to the average cost of $32,325 for preterm infants, according to the March of Dimes. Preterm birth increases the risk of cerebral palsy, intellectual disabilities, vision or hearing loss, respiratory and digestive problems, and other conditions. Prenatal care services assess the mother’s health, screen her for chronic diseases and substance abuse, and promote healthy behaviors. Screening also can help identify problems for the baby that may be treated before, or soon after, birth.
States have enacted legislation and developed programs to improve pregnant women’s health and promote use of prenatal care services.
The District of Columbia and 31 states have “presumptive eligibility” under Medicaid that allows immediate access to prenatal care services for pregnant women while their eligibility is determined.
The District of Columbia and 24 states cover pregnant women with incomes of more than 185 percent of the federal poverty guidelines under Medicaid and the Children’s Health Insurance Program.
As part of Maryland's Babies Born Healthy initiative, health departments have developed a Quick Start prenatal care program for Medicaid-eligible women, including an initial screening on-site, counseling, referral services and help to access ongoing prenatal care.
Colorado’s Prenatal Plus Program targets high-risk, pregnant women enrolled in Medicaid with early and comprehensive prenatal services, such as nutrition counseling, mental health services and care coordination.These changes saved the state $2.7 million in Medicaid costs in 2007, according to the Association of Maternal and Child Health Programs.
The federal Affordable Care Act prohibits most insurers from denying coverage to pregnant women and requires them to cover screening for gestational diabetes, support for breastfeeding and maternity care.
Sources: Association of Maternal and Child Health Programs, 2012; U.S. Department of Health and Human Services, Office on Women’s Health, 2009; Kaiser Family Foundation, 2013; Commonwealth Fund, 2010.
* Late prenatal care is defined as that initiated during the third trimester of pregnancy.
Note: Data are not available for American Samoa, Guam, the Northern Mariana Islands, Puerto Rico and the U.S. Virgin Islands.
Sources: The Kaiser Family Foundation, statehealthfacts.org. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System; Health, United States, 2007. Retrieved Dec. 12, 2012, from http://www.statehealthfacts.org/comparereport.jsp?rep=34&cat=15.
Improving Babies' Health and Reducing Medicaid Costs
National Conference of State Legislatures, LegisBrief, June 2012
Low Birthweight Births
National Conference of State Legislatures, Postcard, November 2011
Investing in Healthy Babies
National Conference of State Legislatures, LegisBrief, March 2009
Forging a Comprehensive Innitiative to to Improve Birth Outcomes and Reduce Infant Mortality: Policy and Program Options for State Planning
Association of Maternal and Child Health Programs, July 2012
Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services
Centers for Disease Control and Prevention
March of Dimes
This webpage was adapted from an NCSL postcard published in February 2013.