About one in 33 babies born in the U.S. is affected by birth defects such as spina bifida, cleft palates and congenital heart defects, according to stats from March of Dimes. Severe birth defects are responsible for about one in five infant deaths. And researchers have now found that babies born at term with birth defects are 45 percent more likely to die if they're covered by Medicaid instead of private health insurance.
The study, published in Morbidity and Mortality Weekly Report from the U.S. Centers for Disease Control and Prevention (CDC), with help from the March of Dimes, looked at the whether or not the baby was premature or carried to full term, how the costs of the birth were paid for, birth defects and how old the baby was when they died. The rates were about the same for premature babies who died after being born.
"Babies born with birth defects often need specialized care, including access to pediatric subspecialists experienced in managing such disorders," said Dr. Paul E. Jarris, senior vice president for Maternal Child Health Impact and deputy medical officer of the March of Dimes.
So what does this mean in broader terms? It's not just those in extreme poverty at risk.
With talk of the likely repeal of the Affordable Care Act (aka Obamacare, which helped millions of Americans get private health insurance), it's possible that lack of access to preventive care and post-neonatal care could cause the number of Medicaid births to rise, leaving lots of babies at risk—especially since many families haven't rebounded since the 2008 recession. During the economic downturn, the troubled economy caused the federal government to shoulder a much bigger share of healthcare spending, and at a faster rate than normal.
Of non-elderly Medicaid recipients across the U.S. in 2015, 42 percent were white, 31 percent were Hispanic, 19 percent were black, and 8 percent were other races or ethnicities.
But when it comes to which birth defects are seen in which babies, it’s clear that non-Hispanic white babies are the least affected compared to others. Black, non-Hispanic babies have higher rates of encephalocele and Trisomy 18 (also known as Edwards syndrome), while Hispanic babies have higher rates of anencephaly, encephalocele and anotia or microtia (malformation of the ear). Non-Hispanic American Indian and Alaska Natives have higher rates of cleft lips and cleft palates, limb deficiencies, anotia or microtia, encephalocele and Trisomy 18, according to CDC data.
Although infant deaths due to birth defects are on the decline in general because of improvements in treatment and early detection, more research needs to be done and strategies to reduce death due to birth defects for all deliveries need to be implemented, regardless of whether they're births paid for by Medicaid or private insurance.