Maryland Population Research Center, University of Maryland at College Park, College Park, Maryland, USA.
Maryland Population Research Center and Department of Sociology, University of Maryland at College Park, College Park, Maryland, USA.
Health Serv Res. 2024 Oct;59(5):e14358. doi: 10.1111/1475-6773.14358. Epub 2024 Jul 15.
To estimate the association of Medicaid coverage of abortion care with cumulative lifetime abortion incidence among women insured by Medicaid.
We use 2016-2019 (Pre-Dobbs) data from the Survey of Women studies that represent women aged 18-44 living in six U.S. states. One state, Maryland, has a Medicaid program that has long covered the cost of abortion care. The other five states, Alabama, Delaware, Iowa, Ohio, and South Carolina, have Medicaid programs that do not cover the cost of abortion care. Our sample includes 8972 women residing in the study states.
Our outcome, cumulative lifetime abortion incidence, is identified using an indirect survey method, the double list experiment. We use a multivariate regression of cumulative lifetime abortion on variables including whether women were Medicaid-insured and whether they were residing in Maryland versus in one of the other five states.
DATA COLLECTION/EXTRACTION METHODS: This study used secondary survey data.
We estimate that Medicaid coverage of abortion care in Maryland is associated with a 37.0 percentage-point (95% CI: 12.3-61.4) higher cumulative lifetime abortion incidence among Medicaid-insured women relative to women not insured by Medicaid compared with those differences by insurance status in states whose Medicaid programs do not cover the cost of abortion care.
We found that Medicaid coverage of abortion care is associated with a much higher lifetime incidence of abortion among individuals insured by Medicaid. We infer that Medicaid coverage of abortion care costs may have a very large impact on the accessibility of abortion care for low-income women.
评估医疗补助计划覆盖堕胎护理与接受医疗补助的女性累积终身堕胎发生率之间的关联。
我们使用了 2016 年至 2019 年（多布斯前）来自妇女调查研究的数据，这些数据代表了居住在美国六个州的 18-44 岁的女性。其中一个州，马里兰州，其医疗补助计划长期以来一直覆盖堕胎护理费用。其他五个州，阿拉巴马州、特拉华州、爱荷华州、俄亥俄州和南卡罗来纳州，其医疗补助计划不涵盖堕胎护理费用。我们的样本包括居住在研究州的 8972 名女性。
我们的结果，即累积终身堕胎发生率，是通过间接调查方法，即双列表实验确定的。我们使用多元回归分析，将累积终身堕胎与包括女性是否接受医疗补助以及她们是否居住在马里兰州与其他五个州中的一个州相关的变量进行回归。
数据收集/提取方法：本研究使用了二手调查数据。
我们估计，马里兰州的医疗补助计划覆盖堕胎护理与接受医疗补助的女性的累积终身堕胎发生率相比，其差异为 37.0 个百分点（95%置信区间：12.3-61.4），而在那些不覆盖堕胎护理费用的州，医疗补助计划对堕胎护理的覆盖与保险状况之间的差异要小得多。
我们发现，医疗补助计划对堕胎护理的覆盖与接受医疗补助的个人堕胎终身发生率之间存在很强的关联。我们推断，医疗补助计划对堕胎护理费用的覆盖可能对低收入女性获得堕胎护理的可及性产生非常大的影响。
