Medicaid policy and pregnancy outcomes: Toward a reproductive autonomy framework.

Abstract:

:State Medicaid programs collectively cover more than 70 million people, and are the largest single payer for pregnancy and delivery in the United States. In this issue, Margerison et al. (Am J Epidemiol. XXXX;XXX(XX):XXXX-XXXX) investigate the extent to which Medicaid expansions to non-pregnant low-income adults under the Affordable Care Act may have improved pre-pregnancy or birth outcomes. The study found Medicaid expansions were not associated with changes in pre-pregnancy health, including smoking and obesity. Similarly, there were no changes in preterm birth or small or large for gestational age attributable to Medicaid expansions. Results were consistent across a range of model specifications and allowing for different lag times between Medicaid expansions and pregnancy. The findings are consistent with prior research finding that pregnancy-specific Medicaid expansions did not uniformly translate to improved pregnancy and birth outcomes. Results should be interpreted in light of the limited contribution that medical services make to overall health and well-being. To reduce the high rates of adverse pregnancy and child health outcomes in the US, Medicaid policy must move toward a reproductive autonomy framework that shifts the focus away from pregnancy-specific benefits and toward a comprehensive and patient-empowering reproductive health paradigm.

journal_name

Am J Epidemiol

authors

Jarlenski M

doi

10.1093/aje/kwaa290

subject

Has Abstract

pub_date

2021-01-11 00:00:00

eissn

0002-9262

issn

1476-6256

pii

6071896

pub_type

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