Infants without health insurance: Racial/ethnic and rural/urban disparities in infant households’ insurance coverage

In order to gain insights into how the effects of the uneven adoption of Medicaid expansion varies across the rural/urban spectrum and between racial/ethnic groups in the United States, this research used the fertility question in the 2011–2015 American Community Survey to link infants’ records to their mothers’ household health insurance status. This preliminary exploration of the Medicaid expansion used logistic regression to examine the probability that an infant will be born without health insurance coverage. Overall, the states that adopted Medicaid expansion improved the health insurance coverage for households with infants. However, rural households with infants report lower percentages of coverage than urban households with infants. Furthermore, the rural/urban gap in health insurance coverage is wider in states that adopted the Medicaid expansion. Additionally, Hispanic infants remain significantly less likely to have health insurance coverage compared to Non-Hispanic White infants. Understanding infant health insurance coverage across ethnic/racial groups and the rural/urban spectrum will become increasingly important as the U.S. population transitions to a minority-majority and also becomes more urban. Although not a perfect solution, our findings showed that the Medicaid expansion of health insurance coverage had a mainly overall positive effect on the percentage of U.S. households with infants who have health insurance coverage.