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Women's Affordability, Access, and Preventive Care After the Affordable Care Act.

Abstract：

INTRODUCTION:Women historically have had difficulty maintaining health insurance, obtaining preventive care, and affording care. The objectives of this study were to describe changes in insurance affordability, healthcare access, and preventive care for women of different income levels after implementation of the Affordable Care Act. METHODS:This was a difference-in-differences analysis of data about U.S. women aged 19-64years from the National Health Interview Survey. This study examined self-reported insurance affordability, access to health care, and preventive services. Changes before (2010-2013) and after (2014-2017) the Affordable Care Act insurance expansions were compared by income (≤138% federal poverty level vs≥400% federal poverty level). Multivariate difference-in-differences analyses adjusting for demographics were expressed as risk differences. RESULTS:The sample represented an estimated 41,106,929 women. After the Affordable Care Act, women with incomes ≤138% federal poverty level, compared with ≥400% federal poverty level, had less difficulty finding affordable insurance (adjusted difference-in-differences: -27.18, 95% CI= -36.37, -18.00); were more likely to have seen/talked to a doctor in 12 months (adjusted difference-in-differences: 3.08, 95% CI=1.29, 4.87), had blood pressure screening (adjusted difference-in-differences: 3.27, 95% CI=1.94, 4.60), cholesterol screening (adjusted difference-in-differences: 5.05, 95% CI=2.45, 7.64), and mammograms (adjusted difference-in-differences: 6.87, 95% CI=3.94, 9.79). CONCLUSIONS:After implementation of the Affordable Care Act, women in all income groups, especially the lowest, reported greater affordability of coverage, access to health care, and receipt of preventive services. Efforts to alter the Affordable Care Act should consider the impact of policy changes on women's health and preventive care.

journal_name

Am J Prev Med

journal_title

American journal of preventive medicine

authors

Lee LK,Monuteaux MC,Galbraith AA

doi

10.1016/j.amepre.2018.11.028

subject

Has Abstract

pub_date

2019-05-01 00:00:00

pages

631-638

issue

eissn

0749-3797

issn

1873-2607

pii

S0749-3797(19)30003-0

journal_volume

pub_type

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Women's Affordability, Access, and Preventive Care After the Affordable Care Act.