<paper_title>Helping Hands, Healthier Infants: The Effect of Medicaid Doula Coverage Mandates on Birth Outcomes
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摘要
This paper evaluates Medicaid doula coverage mandates using a staggered rollout across 32.1 million births and a newly assembled doula-workforce measure; identification rests on policy timing rather than individual take-up [page::1]. The average effect on low birth weight (LBW) is precisely zero, but benefits concentrate among the highest-risk group—Black mothers—where LBW falls by about 0.52 percentage points (roughly 5% of baseline) in states with the longest exposure, with pre-trends flat and effects growing with exposure [page::1]. The mechanism operates through a sizable expansion of the doula workforce (first stage), and a two-stage least squares estimate links increased supply to lower Black LBW, albeit with imprecision due to limited post-period observations [page::1]. Given most adoptions occurred in 2024–2025, the results are credible early evidence rather than a definitive causal claim; replication with more post-period data will be crucial [page::1].
