Racial disparities in infant health conditions have persisted for decades. However, there is surprisingly limited evidence regarding the long-term consequences of these disparities. Using novel linked administrative data from Texas and the shift to Medicaid Managed Care (MMC), I show that MMC-driven declines in infant health worsened cognitive and noncognitive outcomes for Black children, while MMC-driven enhancements in infant health improved noncognitive outcomes and educational attainment for Hispanics. Effects concentrate in low-value added districts for either demographic, suggesting that the long run impacts of changes to early life health conditions are more pronounced in less effective schools for one’s demographic.