Born on Reform: Infant Health in Massachusetts
*Names in bold indicate Presenter
The 2006 Massachusetts reform substantially reduced the uninsured rate, increased access to care, reduced financial hardships and improved child and adult health. Importantly, health insurance was expanded regardless of pregnancy status, and take-up was strongly encouraged through an individual mandate and an extensive outreach campaign. We use restricted data from the Detailed Natality Files to examine the impact of reform on birth weight. Our empirical approach uses a difference-in-differences design, implemented with multivariable regression that compares changes in outcomes in Massachusetts to corresponding changes in a set of control states drawn from the same geographic region. We observe 2.1 million singleton births from 2001 through 2013. Preliminary results suggest negatively signed, but small and non-significant effects of reform on the incidence of low birthweight (coefficient estimate= -0.006; p=0.43). The null effect is precise enough to rule out impacts larger than a 4% decline in the incidence of low birthweight. Similar effects are found across race and ethnic categories. Additional analyses will examine infant mortality and investigate if the effects of reform varied across counties that had low versus high pre-reform insured rates.
Our findings have important policy implications given the similarity of Massachusetts reform and the Affordable Care Act. Particularly, our preliminary results suggest that expanding health insurance coverage to near universal levels, as was accomplished in Massachusetts, may not improve persistently high rates of low birthweight in the U.S.