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  • Title: The Affordable Care Act and Access to Care for Reproductive-Aged and Pregnant Women in the United States, 2010-2016.
    Author: Daw JR, Sommers BD.
    Journal: Am J Public Health; 2019 Apr; 109(4):565-571. PubMed ID: 30789761.
    Abstract:
    OBJECTIVES: To estimate the association between the Affordable Care Act (ACA), health insurance coverage, and access to care among reproductive-aged and pregnant women. METHODS: We performed an observational study comparing current insurance type, cost-related barriers to medical care, and no usual source of care among reproductive-aged (n = 128 352) and pregnant (n = 2179) female respondents to the National Health Interview Survey in the United States, before (2010-2013) and after (2015-2016) the ACA coverage expansions. RESULTS: Among reproductive-aged women, the ACA was associated with a 7.4 percentage-point decrease in the probability of uninsurance (95% confidence interval [CI] = -8.6, -6.2), a 3.6 percentage-point increase in Medicaid (95% CI = 2.5, 4.7), and a 3.1 percentage-point increase in nongroup private coverage (95% CI = 2.1, 4.1). The ACA was also associated with a 1.5 percentage-point decline in cost-related barriers to medical care (95% CI = -2.6, -0.5) and a 2.4 percentage-point reduction in lacking a usual source of care (95% CI = -4.5, -0.3). We did not find significant changes in insurance or cost-related barriers to care for pregnant women. CONCLUSIONS: The ACA was associated with expanded insurance coverage and improvements in access to care for women of reproductive age, particularly for those with lower incomes.
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