How was Medicaid expansion associated with rates of child maltreatment?

Bottom Line: State-level data were analyzed to determine whether Medicaid expansion was associated with changes in rates of physical abuse and neglect of children younger than 6. Medicaid expansion was part of the the Affordable Care Act and prior research suggests it was associated with better financial stability for families and parents’ access to mental health care, both risk factors for child maltreatment. This study included data from 2010 through 2016 for 31 states and the District of Columbia that expanded Medicaid and 19 states that didn’t. Medicaid expansion was associated with a reduction in the reported child neglect rate (422 fewer cases of reported neglect per 100,000 children younger than 6) but not with a significant change to the physical abuse rate, which authors suggest truly may not be there but also could reflect a delayed association not captured by the short study period. Medicaid varies by state and the study may not have captured the effects of program variations that may have affected the association with child maltreatment. Future research should focus on understanding the reasons behind these study findings.

Authors:  Emily C.B.Brown, M.D., M.S., of Seattle Children’s Hospital, and coauthors

(doi:10.1001/jamanetworkopen.2019.5529)

Editor’s Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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Emily C.B.Brown, M.D., M.S.

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