Report on Medicaid Cuts and Their Impact on Mothers, Infants, and Young Children with Emphasis on Sustainable Development Goals (SDGs)

Introduction

In June 2025, the U.S. House passed the One, Big Beautiful Bill Act, which includes significant cuts to Medicaid and other critical supports for mothers, infants, and young children. The Senate version of the bill further exacerbates these challenges. Medicaid coverage for pregnant women and young children has been shown to have lifelong positive impacts on health, education, and earnings outcomes, aligning with several Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being) and SDG 1 (No Poverty). Cuts to Medicaid threaten these gains and risk undermining family economic security and child development.

The Critical Role of Medicaid for Young Families

Medicaid plays an essential role in supporting mothers and young children by providing vital health services and economic security. The following summarizes Medicaid’s importance, highlighting its alignment with SDGs:

1. Pregnancy and Postpartum Coverage
   • Medicaid finances over 40% of U.S. births, covering prenatal care, birth services, and 60 days of postpartum care, which are required core benefits.
   • As of January 2025, 48 states and Washington, D.C. have extended postpartum coverage to 12 months, ensuring stable health coverage for mothers and babies during the critical first year postpartum.
   • This coverage supports SDG 3 by promoting maternal and newborn health.
2. Newborn Babies
   • Newborns whose births are financed by Medicaid receive automatic and continuous coverage for one year.
   • For the 12% of Medicaid-covered births that are preterm, Medicaid funds life-saving neonatal intensive care unit (NICU) services.
   • Coverage includes pediatric primary care and other essential services, contributing to SDG 3.
3. Young Children
   • Medicaid and the Children’s Health Insurance Program (CHIP) cover more than 40% of children under age 6, including 75% of low-income children.
   • In seven states, Medicaid/CHIP covers at least half of children under age 6.
   • Through the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit, children gain access to well-child visits, acute care, and disability prevention services.
   • This supports SDG 3 and SDG 4 (Quality Education) by promoting healthy early childhood development.
4. Parents and Caregivers, Including Child Care Providers
   • The Affordable Care Act’s Medicaid expansion increased coverage for low-income adults, including many parents and caregivers.
   • Nearly 30% of child care workers were covered by Medicaid in 2023, supporting working parents and small businesses.
   • This coverage enhances family economic security and supports SDG 8 (Decent Work and Economic Growth).

Implications of Medicaid Cuts

The proposed Medicaid cuts, estimated at nearly one trillion dollars, pose severe risks to the health and economic stability of young families. Key concerns include:

• Loss of Health Coverage: Millions of parents and children risk losing Medicaid coverage due to work requirements and administrative barriers, undermining SDG 3.
• Increased Economic Instability: Reduced access to Medicaid threatens family economic security, counteracting SDG 1.
• Adverse Child Health Outcomes: Uninsured women face higher risks of untreated health conditions before pregnancy, increasing risks for healthy births.
• Challenges in Rural and Small Town Communities: Medicaid is vital for rural hospitals and obstetric services; cuts will force pregnant women to travel longer distances for care, exacerbating health disparities and impacting SDG 10 (Reduced Inequalities).
• Risk to Optional Medicaid Services: Budget pressures may lead states to roll back optional services such as postpartum coverage extensions, doula care, community health workers, home visiting, and school-based services, which support SDG 3 and SDG 4.

Alignment with Sustainable Development Goals (SDGs)

The Medicaid program supports multiple SDGs, including but not limited to:

• SDG 1: No Poverty – By providing health coverage and economic security to low-income families.
• SDG 3: Good Health and Well-being – Through comprehensive maternal, newborn, and child health services.
• SDG 4: Quality Education – By supporting early childhood development and preventive health care.
• SDG 8: Decent Work and Economic Growth – By covering caregivers and child care workers, enabling workforce participation.
• SDG 10: Reduced Inequalities – By addressing health disparities in rural and underserved communities.

Conclusion

Medicaid cuts threaten to reverse progress in maternal and child health and economic security, undermining key Sustainable Development Goals. Policymakers must consider the long-term consequences of these budget decisions on young families and the broader societal goals of health, equity, and well-being.

1. Relevant Sustainable Development Goals (SDGs) Addressed in the Article

1. SDG 3: Good Health and Well-being
   • The article focuses heavily on health coverage for pregnant women, infants, and young children through Medicaid, highlighting the importance of access to essential health services and maternal and child health outcomes.
2. SDG 1: No Poverty
   • Medicaid’s role in supporting family economic security and preventing economic instability for low-income families is emphasized, linking to poverty reduction.
3. SDG 10: Reduced Inequalities
   • The article discusses Medicaid coverage for low-income families, rural communities, and vulnerable populations, addressing health and economic inequalities.
4. SDG 4: Quality Education
   • Early childhood development programs supported by Medicaid are mentioned, connecting to children’s early development and educational outcomes.
5. SDG 8: Decent Work and Economic Growth
   • Medicaid coverage for child care providers and working parents supports workforce participation and small businesses.

2. Specific Targets Under the Identified SDGs

1. SDG 3: Good Health and Well-being
   • Target 3.1: Reduce the global maternal mortality ratio by ensuring access to quality prenatal, birth, and postnatal care (Medicaid covers prenatal, birth, and postpartum services).
   • Target 3.2: End preventable deaths of newborns and children under 5 years of age (Medicaid covers newborn care including NICU for preterm babies and pediatric primary care).
   • Target 3.8: Achieve universal health coverage, including financial risk protection and access to quality essential health-care services (Medicaid expansion and coverage for low-income families).
2. SDG 1: No Poverty
   • Target 1.2: Reduce at least by half the proportion of people living in poverty in all its dimensions (Medicaid supports family economic security by reducing medical costs and instability).
3. SDG 10: Reduced Inequalities
   • Target 10.2: Empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, or economic status (Medicaid coverage for marginalized groups including rural populations and low-income families).
4. SDG 4: Quality Education
   • Target 4.2: Ensure that all children have access to quality early childhood development, care and pre-primary education (Medicaid supports early childhood programs and interventions).
5. SDG 8: Decent Work and Economic Growth
   • Target 8.5: Achieve full and productive employment and decent work for all women and men (Medicaid coverage for child care workers and working parents supports workforce participation).

3. Indicators Mentioned or Implied in the Article to Measure Progress

1. Health Coverage Indicators
   • Percentage of births covered by Medicaid (article states Medicaid pays for more than 40% of U.S. births).
   • Number or percentage of states extending postpartum Medicaid coverage to 12 months (48 states and D.C. as of January 2025).
   • Coverage rates of Medicaid/CHIP for children under age 6 (more than 40% nationally, with some states covering at least half).
   • Medicaid enrollment rates among child care workers (nearly 30% in 2023).
2. Health Outcome Indicators
   • Rates of preterm births covered by Medicaid (12% of Medicaid-covered births are preterm).
   • Access to essential maternal and child health services (prenatal care, NICU, pediatric primary care).
   • Incidence of untreated health conditions among uninsured women prior to pregnancy (implied risk factor).
3. Economic Indicators
   • Measures of family economic security and stability linked to Medicaid coverage (implied through references to economic instability risks).
   • Impact of Medicaid cuts on state budgets and rural hospital revenues (implied financial indicators).
4. Access and Equity Indicators
   • Coverage disparities in rural versus urban areas (Medicaid’s role in rural communities highlighted).
   • Availability of optional Medicaid services and coverage groups (e.g., doula care, home visiting, school-based services at risk).

4. Table of SDGs, Targets, and Indicators

Source: ccf.georgetown.edu