Swartz Jonas J, Meskey Joseph, Stuart Gretchen S, Rodriguez Maria I
Division of Women's Community and Population Health, Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina
Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, North Carolina.
Ann Fam Med. 2021 Jan-Feb;19(1):38-40. doi: 10.1370/afm.2615.
One-half of women in the United States use Medicaid during pregnancy. Women living in states that did not expand Medicaid under the Patient Protection and Affordable Care Act (ACA) are at risk of losing coverage post partum. We analyzed Medicaid claims and vital statistics for the state of North Carolina for the period 2011 to 2017. North Carolina did not expand Medicaid but did alter Medicaid enrollment to meet ACA requirements. After implementation, enrollment in full Medicaid during pregnancy almost doubled, and enrollment in Medicaid for pregnant women decreased. Full Medicaid offers more comprehensive coverage and does not expire at 60 days post partum, allowing for access to crucial preventive health services including contraception and primary care.
在美国，有一半的女性在孕期使用医疗补助计划（Medicaid）。生活在那些未根据《患者保护与平价医疗法案》（ACA）扩大医疗补助计划覆盖范围的州的女性，在产后有失去医保覆盖的风险。我们分析了北卡罗来纳州2011年至2017年期间的医疗补助计划索赔数据和人口动态统计数据。北卡罗来纳州没有扩大医疗补助计划，但确实调整了医疗补助计划的参保情况以满足ACA的要求。实施之后，孕期全额医疗补助计划的参保人数几乎翻了一番，而孕妇医疗补助计划的参保人数则有所下降。全额医疗补助计划提供更全面的保险覆盖，并且不会在产后60天到期，从而能够获得包括避孕和初级保健在内的关键预防性健康服务。
