Infants' Non-Enrollment in Medicaid after Medicaid-Financed Birth: an Analysis of Pregnancy Risk Assessment Monitoring System (PRAMS) Data.

Objectives: To characterize the proportion of Medicaid-eligible infants experiencing gaps in Medicaid coverage during early infancy and to determine whether infants without Medicaid coverage were covered by other plans or not at all.

Study design: Infants with Medicaid-financed births from three states participating in the 2016-2020 Pregnancy Risk Assessment Monitoring System (PRAMS) were included (N=3,658). Infant insurance coverage (Medicaid, non-Medicaid, none) was assessed at the time of the PRAMS survey, typically around four months of age.

Results: Fifteen percent of infants had non-Medicaid insurance coverage, two percent were uninsured, and 83% had Medicaid coverage after Medicaid-financed birth. The strongest predictor of infant uninsurance was maternal uninsurance or non-Medicaid coverage before pregnancy.

Conclusion: Some presumably eligible infants are not enrolled in Medicaid or experience lapses in Medicaid coverage. Informing families about infants' coverage eligibility and supporting families during the enrollment process would especially benefit families with no pre-pregnancy experience with Medicaid.