![]() 5 Approximately 45% of US pregnancies are unintended, with an even higher proportion (55.9%) classified as unintended among low-income women (<150% federal poverty level). ![]() 4Ĭontraceptive care is an essential health service for women of reproductive age. 2, 3 It is critical to understand the effects of Medicaid expansion programs, which the ACA requires to cover birth control without cost-sharing, on access to care. 1 Michigan’s Section 1115 Medicaid Expansion waiver program, the Healthy Michigan Plan (HMP), began enrolling patients in April 2014 and now provides health insurance to approximately 650 000 low-income adults, including approximately 200 000 Michigan women of reproductive age. Michigan is among the 32 states and District of Columbia that have expanded their Medicaid programs under the Patient Protection and Affordable Care Act (ACA). This finding suggests that Medicaid expansion is associated with improved access to family planning services, which may enable low-income women to maintain optimal reproductive health. After adjusting, those most likely to report increased access were women without health insurance coverage in the year preceding HMP enrollment (adjusted odds ratio, 2.02 95% CI, 1.41-2.89) compared with women with health insurance for the full 12 months preceding enrollment younger women (aOR for 19-24 years, 2.80 aOR for 25-34 years, 2.35 ) compared with women aged 35 to 44 years and women with a recent visit to a primary care clinician (aOR 1.69 95% CI, 1.03-2.76) compared with women without a primary care visit in the preceding 12 months.Ĭonclusions and Relevance One in 3 women of reproductive age reported better ability to access birth control and family planning services through HMP compared with before enrollment. Overall, 35.5% (95% CI, 32.2%-39.0%) reported increased access to family planning services. Main Outcomes and Measures Self-reported change in access to birth control and family planning services through HMP (better, worse, about the same, or don’t know/doesn’t apply), compared with before enrollment. Dates of data analysis were from January 27 through September 18, 2017. ![]() The sample was weighted to 113 565 women. Surveys were conducted with a computer-assisted telephone interviewing system in English, Arabic, and Spanish. Interviewers completed surveys for 4090 sampled enrollees, of whom 1166 were women aged 19 to 44 years. Objective To evaluate the association of Medicaid expansion coverage with access to birth control and family planning services among women of reproductive age enrolled in the Michigan expansion plan.ĭesign, Setting, and Participants In a survey study, from January 13 through December 15, 2016, telephone surveys of a stratified sample of enrollees in Michigan’s Section 1115 Medicaid Expansion waiver program, the Healthy Michigan Plan (HMP), were conducted. It is vital to understand whether expanded health insurance coverage of low-income individuals improves access to family planning services as a first step toward improving reproductive health outcomes. ![]() Importance To date, 32 states and the District of Columbia have expanded Medicaid programs under the Patient Protection and Affordable Care Act. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography. ![]()
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