Medicaid Expansion and Perinatal Health Outcomes: A Quasi-Experimental Study.

Autor: Modrek S; Health Equity Institute, San Francisco State University, San Francisco, CA, USA., Collin DF; Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA., Hamad R; Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA.; Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA., White JS; Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA. juswhite@bu.edu.; Department of Health Law, Policy and Management, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA. juswhite@bu.edu.
Jazyk: angličtina
Zdroj: Maternal and child health journal [Matern Child Health J] 2024 May; Vol. 28 (5), pp. 959-968. Date of Electronic Publication: 2024 Jan 20.
DOI: 10.1007/s10995-023-03879-y
Abstrakt: Objective: There has been little evidence of the impact of preventive services during pregnancy covered under the Affordable Care Act (ACA) on birthing parent and infant outcomes. To address this gap, this study examines the association between Medicaid expansion under the ACA and birthing parent and infant outcomes of low-income pregnant people.
Methods: This study used individual-level data from the 2004-2017 annual waves of the Pregnancy Risk Assessment Monitoring System (PRAMS). PRAMS is a surveillance project of the Centers for Disease Control and Prevention and health departments that annually includes a representative sample of 1,300 to 3,400 births per state, selected from birth certificates. Birthing parents' outcomes of interest included timing of prenatal care, gestational diabetes, hypertensive disorders of pregnancy, cigarette smoking during pregnancy, and postpartum care. Infant outcomes included initiation and duration of breastfeeding, preterm birth, and birth weight. The association between ACA Medicaid expansion and the birthing parent and infant outcomes were examined using difference-in-differences estimation.
Results: There was no association between Medicaid expansion and the outcomes examined after correcting for multiple testing. This finding was robust to several sensitivity analyses.
Conclusions for Practice: Study findings suggest that expanded access to more complete insurance benefits with limited cost-sharing for pregnant people, a group that already had high rates of insurance coverage, did not impact the birthing parents' and infant health outcomes examined.
(© 2024. The Author(s).)
Databáze: MEDLINE
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