Rebecca Myerson is an assistant professor in the Department of Population Health Sciences at the University of Wisconsin-Madison, in Madison, Wisconsin.
Samuel Crawford is a PhD student in the Department of Pharmaceutical and Health Economics at the University of Southern California School of Pharmacy, in Los Angeles, California.
Health Aff (Millwood). 2020 Nov;39(11):1883-1890. doi: 10.1377/hlthaff.2020.00106.
The period before pregnancy is critically important for the health of a woman and her infant, yet not all women have access to health insurance during this time. We evaluated whether increased access to health insurance under the Affordable Care Act Medicaid expansions affected ten preconception health indicators, including the prevalence of chronic conditions and health behaviors, birth control use and pregnancy intention, and receipt of preconception health services. By comparing changes in outcomes for low-income women in expansion and nonexpansion states, we document greater preconception health counseling, prepregnancy folic acid intake, and postpartum use of effective birth control methods among low-income women associated with Medicaid expansion. We do not find evidence of changes on the other preconception health indicators examined. Our findings indicate that expanding Medicaid led to detectable improvements on a subset of preconception health measures.
怀孕前阶段对妇女及其婴儿的健康至关重要，但并非所有妇女在此期间都能获得医疗保险。我们评估了平价医疗法案（ACA）下医疗补助扩大范围是否增加了医疗保险的可及性，从而对包括慢性疾病和健康行为、避孕措施使用和妊娠意愿以及接受孕前保健服务在内的十个孕前健康指标产生了影响。通过比较扩张州和非扩张州低收入妇女的结果变化，我们记录了与医疗补助扩张相关的低收入妇女孕前健康咨询、叶酸摄入和产后有效避孕方法使用的增加。我们没有发现其他孕前健康指标有变化的证据。我们的研究结果表明，扩大医疗补助范围导致部分孕前健康指标有了明显改善。
