Sponsor
This work was supported by funding from Stanford Maternal and Child Health Research Institute, United States.
Published In
Women's Health Issues
Document Type
Article
Publication Date
1-8-2022
Subjects
Medicaid -- Health Care
Abstract
Objectives
Medicaid expansion under the Affordable Care Act (ACA) improved access to reproductive health care for low-income women and birthing people who were previously ineligible for Medicaid. We aimed to evaluate if the expansion affected the risk of having a short interpregnancy interval (IPI), a preventable risk factor for adverse pregnancy outcomes.
Methods
We evaluated parous singleton births to mothers aged 19 or older from U.S. birth certificate data 2009–2018. We estimated the effect of residing in a state that expanded Medicaid access (expansion status determined at 60 days after the prior live birth) on the risk of having a short IPI (months) using difference-in-differences (DID) methods in linear probability models. We stratified the analyses by maternal characteristics and county-level reproductive health care access.
Results
Overall risk of short IPI was 14.9% in expansion states and 16.3% in non-expansion states. The expansion was not associated with a significant change in risk of having a short IPI (adjusted mean percentage point change 1.24 [-1.64, 4.12]). Stratified results also did not provide support for an association.
Conclusions
ACA Medicaid expansion did not have an impact on risk of short IPI. Preventing short IPI may require more comprehensive policy interventions in addition to health care access.
Rights
© 2021 The Author(s). Published by Elsevier Inc. on behalf of Jacobs Institute of Women's Health, George Washington University.
Locate the Document
DOI
10.1016/j.whi.2021.12.004
Persistent Identifier
https://archives.pdx.edu/ds/psu/37033
Citation Details
Liu, C., Snowden, J. M., Rossin-Slater, M., Torche, F., DiTosto, J. D., & Carmichael, S. L. (2022). Impact of Medicaid Expansion on Interpregnancy Interval. Women's Health Issues.