Left Behind: Medicaid Immigrant Exclusions and Access to Maternal Health Care Across the Reproductive-Perinatal Continuum.

This article examines how immigrant exclusions from Medicaid contribute to maternal health inequities across the reproductive-perinatal continuum in the United States. Through interviews with 31 policymakers, researchers, and program administrators, the study identifies a patchwork of limited and complex safety-net programs that provide some access to care for immigrants ineligible for Medicaid, but result in fragmented and often inadequate coverage. Immigrant Medicaid policy is shaped by a hierarchy of deservingness based on documentation status, with the "unborn child" option offering narrow prenatal coverage tied to fetal citizenship, while Trump-era public charge rules and the broader political climate have created a chilling effect that discourages benefit uptake. The findings highlight systemic racism embedded in federal and state policies and administrative burdens that restrict immigrant access to comprehensive maternal health care, underscoring the need for inclusive policy reforms to address maternal health disparities among immigrant populations.