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Purpose: Despite expanding health insurance coverage under the Patient Protection and Affordable Care Act (ACA), many Americans struggle with financial barriers to health care. Medicaid expansion was meant to help alleviate these barriers, particularly for rural communities, but has shown mixed results. The American Indian and Alaska Native (AI/AN) community, which faces both racial and geographic disparities, is a group that should benefit from Medicaid expansion.
View Article and Find Full Text PDFEffects of the Affordable Care Act on Contraception, Pregnancy, and Pregnancy Termination Rates.
Obstet Gynecol
February 2025
Department of Cardiology, the Department of Obstetrics and Gynecology, and the Division of Research, Kaiser Permanente Northern California, and Graduate Medical Education, Kaiser Permanente Oakland Medical Center, Oakland, and the Division of Research, Kaiser Permanente, Pleasanton, California.
Objective: To investigate the effects of the Affordable Care Act (ACA) and its elimination of cost sharing on contraception utilization, pregnancy rates, and abortion rates.
Methods: We conducted a retrospective cohort study within a health care system serving more than 4.5 million insured members across 21 medical centers and 250 clinics.
Health Care Utilization and Costs for Older Adults Aging Into Medicare After the Affordable Care Act.
JAMA Health Forum
January 2025
Department of Internal Medicine, University of Michigan, Ann Arbor.
Importance: The Affordable Care Act (ACA) expanded Medicaid and Marketplace insurance to nonelderly adults in 2014, but whether these policies improved outcomes later in life is unknown.
Objective: To examine whether exposure to ACA expansions during middle age (50-64 years) was associated with changes in health, utilization, and spending after these adults entered Medicare at 65 years of age.
Design, Setting, And Participants: This serial analysis of the Health and Retirement Study cohort linked to Medicare enrollment and claims data from January 1, 2010, to December 31, 2018.
Provider capacity during Medicaid expansion and a public health emergency.
Am J Manag Care
December 2024
University of Missouri Truman School of Government and Public Affairs, 615 Locust St, E004 Locust Street Bldg, Columbia, MO 65211. Email:
Objectives: To assess the capacity of Medicaid providers to take on new patients during a time of unprecedented growth in program enrollment due to Medicaid expansion and the COVID-19 public health emergency.
Study Design: We conducted a survey of Medicaid providers in Missouri in 2023 about their patient load and capacity to accept new patients.
Methods: We recruited 141 Missouri Medicaid providers through probability sampling and 109 additional providers through convenience sampling for a total sample size of 250, representing 0.
Factors affecting women's access to primary care in the United States since the Affordable Care Act: A mixed-methods systematic review.
PLoS One
December 2024
Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, Lancashire, United Kingdom.
Background: In the United States, the Affordable Care Act (ACA) expanded public and private health coverage, increased health insurance affordability, reduced healthcare costs, and improved healthcare quality for many. Despite ACA provisions, lack of insurance and other factors continue to affect working-age women's access to primary care services.
Methods: We conducted a mixed-method systematic review to identify factors that affect women's access to primary care services since the ACA.
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