Kate W Strully, Pinka Chatterji, Han Liu, Soojin Han, Lawrence Schell
{"title":"Effects Of Medicaid Expansions On Coverage, Prenatal Care, And Health Among American Indian/Alaska Native Women.","authors":"Kate W Strully, Pinka Chatterji, Han Liu, Soojin Han, Lawrence Schell","doi":"10.1377/hlthaff.2023.00672","DOIUrl":null,"url":null,"abstract":"<p><p>American Indian/Alaska Native (AI/AN) women experience distinct political and health care environments and possess unique health risks and resources. We tested whether state Medicaid expansions under the Affordable Care Act were associated with health insurance, prenatal care, health conditions, and birth outcomes among AI/AN women. Using data from the 2010-19 American Community Survey and 2010-19 US birth certificates, we used a difference-in-differences study design to compare outcomes among AI/AN women before and after Medicaid expansions. Medicaid expansions increased the proportion of AI/AN women reporting health care coverage from both Medicaid and the Indian Health Service (IHS), with larger effects among women living in areas with relatively high percentages of reservation land. Consistent with prior research on the broader population of women, Medicaid expansions had no effects on first-trimester prenatal care usage or birthweight among AI/AN women. We found mixed evidence of increased rates of prepregnancy chronic conditions after the expansions. Our findings demonstrate the importance of Medicaid, the IHS, and tribal health systems as sources of health care coverage for AI/AN women of childbearing age.</p>","PeriodicalId":50411,"journal":{"name":"Health Affairs","volume":null,"pages":null},"PeriodicalIF":8.6000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11340263/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health Affairs","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1377/hlthaff.2023.00672","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
Abstract
American Indian/Alaska Native (AI/AN) women experience distinct political and health care environments and possess unique health risks and resources. We tested whether state Medicaid expansions under the Affordable Care Act were associated with health insurance, prenatal care, health conditions, and birth outcomes among AI/AN women. Using data from the 2010-19 American Community Survey and 2010-19 US birth certificates, we used a difference-in-differences study design to compare outcomes among AI/AN women before and after Medicaid expansions. Medicaid expansions increased the proportion of AI/AN women reporting health care coverage from both Medicaid and the Indian Health Service (IHS), with larger effects among women living in areas with relatively high percentages of reservation land. Consistent with prior research on the broader population of women, Medicaid expansions had no effects on first-trimester prenatal care usage or birthweight among AI/AN women. We found mixed evidence of increased rates of prepregnancy chronic conditions after the expansions. Our findings demonstrate the importance of Medicaid, the IHS, and tribal health systems as sources of health care coverage for AI/AN women of childbearing age.
期刊介绍:
Health Affairs is a prestigious journal that aims to thoroughly examine significant health policy matters both domestically and globally. Our publication is committed to addressing issues that are relevant to both the private and public sectors. We are enthusiastic about inviting private and public decision-makers to contribute their innovative ideas in a publishable format. Health Affairs seeks to incorporate various perspectives from industry, labor, government, and academia, ensuring that our readers benefit from the diverse viewpoints within the healthcare field.