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Necessary but Not Sufficient

Bernard Guyer, MD, MPH

JAMA. 1990;264(17):2264-2265.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

The findings reported by Piper and colleagues¹ that appear in this issue of THE JOURNAL should not be baffling or discouraging to policymakers concerned with reducing the nation's infant mortality rate. The authors evaluate the effects in Tennessee of the first of a series of expansions in Medicaid eligibility that were intended to improve the outcome of pregnancy among women with low incomes. This report, and others that will surely follow, should help shape future maternal and child health financing policies.

Since the early 1980s, Congress has repeatedly amended Medicaid (Omnibus Budget Reconciliation Act, 1981, 1986, 1987, and 1989; Deficit Reduction Act, 1984; Consolidated Omnibus Budget Reconciliation Act, 1985; and Catastrophic Care, 1988) to expand incremental eligibility for pregnant women and infants.² Congress initially conceptualized infant mortality as a problem of access to health care. Congressional action was influenced by the findings of the Institute of Medicine's Committee . . . [Full Text PDF of this Article]

Author Affiliations
From the Department of Maternal and Child Health, The Johns Hopkins University School of Hygiene and Public Health, Baltimore, Md.

Footnotes
Reprint requests to Department of Maternal and Child Health, The Johns Hopkins University School of Hygiene and Public Health, Hampton House, 624 N Broadway, Baltimore, MD 21205 (Dr Guyer).

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