Association for Public Policy Analysis & Management

Medicaid coverage is dependent on means tested eligibility criteria, which are based on dynamic family circumstances. Continuous Medicaid coverage also requires annual completion of complex renewal paperwork. Changes in age, family structure, employment, and residency all provide opportunities for gaps in coverage. Teen mothers and their children are particularly vulnerable to gaps in coverage as they navigate the transition to adulthood. Families with inconsistent coverage have decreased access to community expertise and services. While previous research on Medicaid consistency examines its effects on service utilization patterns and specific health outcomes, it is also important to understand the impact of coverage stability on parenting stress and child behaviors, which can affect numerous health behaviors and family outcomes across the life course. Structured interviews were conducted with African American teen mothers participating in an evaluation program at baseline, when their children were, on average 2 moths old (n=150), and 12-months (n=124), and 24-months (n=111) later. While 93% of teen mothers in the sample ever received Medicaid coverage, only 35% received Medicaid coverage consistently across the child’s first two years. Mothers with inconsistent Medicaid coverage had significantly higher parenting stress scores (R .434, p=.000) (β=-9.617, p = .000) than mothers with consistent coverage. Children of mothers with inconsistent Medicaid coverage had significantly higher internalizing behavior scores (R .339, p=.003) (β= -7.484, p = .003) than children of mothers with consistent coverage. Parenting stress partially mediated the relationship between Medicaid coverage consistency and child internalizing behavior. Inconsistent Medicaid coverage was not significantly associated with child externalizing behavior. These preliminary findings suggest that policies aimed at improving the consistency of Medicaid coverage for teen mothers will reduce parenting stress and improve child behavior.