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Unequal CoverageThe Experience of Health Care Reform in the United States$
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Jessica M. Mulligan and Heide Castañeda

Print publication date: 2017

Print ISBN-13: 9781479897001

Published to NYU Press Scholarship Online: September 2018

DOI: 10.18574/nyu/9781479897001.001.0001

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Stratification through Medicaid

Stratification through Medicaid

Public Prenatal Care in New York City

(p.102) 4 Stratification through Medicaid
Unequal Coverage

Elise Andaya

NYU Press

Elise Andaya’s chapter focuses on Medicaid-covered prenatal care in New York State to illustrate how health care for low-income people after the passage of the ACA reconstituted preexisting patterns of exclusion and reinforced long-standing moral divisions between the “righteous” and the “undeserving” poor. Stratification was especially evident in pervasive beliefs about the disposability of poor people’s time. In addition, poor women were singled out as medically and socially high-risk patients and their inclusion in the body politic was only temporary. Shortly after pregnancy ended, women and their infants were reincorporated into society through new or existing categories of stratified health citizenship, including non-citizenship. This chapter suggests we must go beyond understanding lack of coverage to also take account of how different forms of health coverage can also contribute to experiences of health inequality.

Keywords:   stratified health citizenship, New York, Medicaid, undeserving poor, health inequality, exclusion, moral divisions, prenatal care, high-risk patients

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