An Alabama Department of Public Health report released on Tuesday shows a link between birth outcomes and health insurance, the AP/Decatur Daily reports. The report, by the department's Center for Health Statistics, examined birth certificates for 60,262 live births, finding that:
Infants born in Alabama in 2005 were more than three times likely to die in the first year if their mothers paid for their deliveries out-of-pocket than those with private health insurance;

Infants in deliveries covered by Medicaid were 40% more likely to have low birthweights and 60% more likely to die than infants with private insurance;

White women were more likely to have private health insurance than minority women;

Women with less than 12 years of education were more likely to be covered by Medicaid;

48% of deliveries were covered by Medicaid, 48% by private insurance and 4% by patients or other means (Hunter, AP/Decatur Daily, 9/5);

Medicaid covered deliveries for nearly four out of every five births among teenage girls and 40% of births involving women ages 20 to 34;

Private insurance covered nearly 80% of births among women ages 35 and older; and

Nearly all women with private insurance received prenatal care within the first trimester, compared with 74.7% of women with Medicaid coverage (Delinski, Florence Times Daily, 9/5).

Report researcher Albert Woolbright said the results were "about what you would expect." He added, "If we can prevent teen births and try to move the childbearing pattern from the lower age groups to ages 25-35 so that the mothers can finish college," birth outcomes would improve. Although Alabama's infant mortality rate has been declining since 1998, according to health officials, the rate rose in 2005.

Don Williamson, a state health officer, said the data do not mean Medicaid does not provide quality health care. He added, "It's the other factors that make one eligible for Medicaid -- teenage moms, income, lower education status -- all of those are the drivers for infant mortality. In that respect, Medicaid eligibility simply becomes a marker" (AP/Decatur Daily, 9/5).

"Finding ways to increase the number of women with insurance should greatly reduce the number of mothers with late or no prenatal care and improve pregnancy outcomes by reducing the incidence of low-birthweight babies," Williamson said (Florence Times Daily, 9/5).

According to the report authors, the state should expand Medicaid income eligibility from 133% of the federal poverty level to 175% or 200% of the poverty level. In addition, the state should provide health insurance to pregnant women before they deliver through SCHIP (AP/Decatur Daily, 9/5).

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