Medicaid Picking Up the Tab for Out-of-Wedlock Childbirth

According to researchers from the George Washington University (GWU) School of Public Health, in 2010, almost half of all births in the United States were paid for by Medicaid, and that rate is only going to go up. Medicaid was responsible for 48% of the 3.8 million births in 2010, an increase of 90,000 births from 2008, which was an 8% increase during that period.

Lead investigator Anne Markus, an associate professor of health policy at GWU, said, "As states expand coverage, low-income women of childbearing age will be able to obtain more continuous coverage before and between pregnancies. Now, for the first time, researchers will have a comprehensive baseline that will help them determine how increased access to services might change pregnancies and ultimately birth outcomes.”

The average age of marriage is increasing to 26.5 years old for women and 28.7 years old for men. That's up from ages 23 and 26 in 1990, respectively. But, the median age of first birth for a woman is now 25.7 -- meaning that about 48 percent of first births happening outside of wedlock.

"The ones who are not marrying are the ones who don't have the job prospects, don't have the economic stability," Stephanie Coontz, a co-chair of the non-profit Council on Contemporary Families who was not involved in the report, told USA Today.

But, twenty-somethings aren't waiting to have children, according to the report. Forty-four percent of American women will have given birth by the time they are 25, but only 38 percent are married by that age. By 30, two-thirds of women will have had a child out of wedlock.

The average age of first birth for women who drop out of high school is 20, while their average married age is 25. Eighty-three percent of first births to non-high school graduates are to unwed mothers.

The biggest rise in unmarried pregnancy is among the 54 percent of "middle American" women, which include women who have graduated high school and completed some college but do not have a degree. In this group, the average age of having their first child is 24, and they are married at 27. Fifty-eight percent of the first births in this group are to unwed mothers.

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Medicaid is funded with general revenues so, insofar as the federal and state governments are going broke, so is Medicaid. Costs for the program are rising. According to the Urban Institute, “Between 2011 and 2020 overall Medicaid expenditures are projected to grow at 8.7 percent per year by the CMS actuaries and 8.1 percent per year by CBO. Increases in overall Medicaid spending will continue to be driven by enrollment growth largely because of the Affordable Care Act.” Indeed, with the mandates passed in the 2010 reform law, enrollment is expected to rise to 27.4 percent by 2019.