Recent changes in health care policy have shifted the landscape of family planning coverage in the U.S., and it is important to understand how state-level policies may affect individuals differently based on their access to enabling resources. Using 2015 national birth records, we investigate associations between Medicaid expansion, Medicaid family planning waivers, and abortion restriction on percentage of Medicaid-covered births within <6 month inter-pregnancy intervals, and whether these associations are moderated by county urban-rural status. Preliminary logistic regressions indicate that among Medicaid deliveries, associations between family planning waivers and very short birth spacing were strongest in large central metropolitan counties; associations between degree of abortion restriction and very short birth spacing were strongest in micropolitan and non-core counties. These findings are consistent with the idea that coverage does not necessarily confer access, and with literature suggesting that individuals may experience state health care policies differently in urban vs. rural areas.
Presented in Session 10. Fertility, Family Planning, Sexual Behavior & Reproductive Health 2