Summary: Pursuant to a congressional request, GAO investigated the extent to which Medicaid beneficiaries and uninsured women experience difficulties in obtaining access to prenatal care to determine the: (1) timing and number of their prenatal care visits; and (2) barriers they perceived as preventing them from obtaining care earlier or more often.
GAO found that: (1) 63 percent obtained insufficient prenatal care; (2) those women most likely to obtain insufficient care were uninsured, poorly educated, black or Hispanic teenagers, or women from large urban areas; (3) those most likely to obtain adequate care were well-educated, white, residing in rural communities, in their early 30's, or Medicaid recipients; (4) lack of money to pay for care, lack of transportation, and unawareness of the pregnancy prevented women from obtaining earlier or more frequent prenatal care; (5) there was little information on the effectiveness of states' and communities' initiatives for improving access to prenatal care; (6) 19 states expanded Medicaid eligibility to pregnant women, although none implemented presumptive eligibility; (7) if states expanded Medicaid coverage of pregnant women, reduced intensive care and long-term institutional costs would offset initial costs; (8) increases in Medicaid reimbursement rates for maternity services would not improve access to care as much as expanding eligibility; and (9) states believed that Maternal and Child Health block grants were insufficient for needed prenatal services.
