Evaluating the effect of Medicaid expansion on access to preventive reproductive care for women in Oregon

Publication date: Available online 12 November 2019Source: Preventive MedicineAuthor(s): Susannah Gibbs, S. Marie Harvey, Linh Bui, Lisa Oakley, Jeff Luck, Jangho YoonAbstractWe evaluated the effect of the Affordable Care Act (ACA) Medicaid expansion on receipt of preventive reproductive services for women in Oregon. First, we compared service receipt among continuing Medicaid enrollees pre- and post-ACA. We then compared receipt among new post-ACA Medicaid enrollees to receipt by continuing enrollees after ACA implementation. Using Medicaid enrollment and claims data, we identified well-woman visits, contraceptive counseling, contraceptive services, sexually transmitted infection (STI) screening, and cervical cancer screening among women ages 15–44 in years when not pregnant. For pre-ACA enrollees, we assessed pre-ACA receipt in 2011–2013 (n = 83,719) and post-ACA receipt in 2014–2016 (n = 103,225). For post-ACA enrollees we similarly assessed post-ACA service receipt (n = 73,945) and compared this to service receipt by pre-ACA enrollees during 2014–2016. We estimated logistic regression models to compare service receipt over time and between enrollment groups. Among pre-ACA enrollees we found lower receipt of all services post-ACA. Adjusted declines ranged from 7.0 percentage points (95% CI: −7.5, −6.4) for cervical cancer screening to 0.4 percentage points [−0.6, −0.2] for STI screening. In 2014–2016, post-ACA enrollees differed significantly ...
Source: Preventive Medicine - Category: International Medicine & Public Health Source Type: research