Impacts of the ACA Medicaid Expansion on Pregnancy Health and Outcomes in the United States

Claire Margerison , Michigan State University
Colleen MacCallum, Michigan State University
Jiajia Chen, University of Illinois at Chicago
Yasamean Zamani-Hank, Michigan State University
Robert Kaestner, University of Illinois at Chicago

Preconception (vs. prenatal) healthcare has been heralded as an essential method of identifying and managing risk factors of poor pregnancy health and outcomes. However, as of 2012, over one-third of low-income women of reproductive age lacked health insurance, limiting access to preconception care. The 2014 Medicaid expansion resulted in a natural experiment offering an opportunity to examine effects of this policy. The objective of our study is to test the hypothesis that increasing Medicaid eligibility for low-income, non-pregnant women of reproductive age improved measures of pre-pregnancy and pregnancy health and reduced the prevalence of adverse birth outcomes. In our extended abstract, we provide descriptive analyses of our data, the U.S. natality data 2010-2016 and our two methodological approaches: a difference-in-difference analysis and an approach that constructs a simulated measure of Medicaid eligibility taking advantage of variation in eligibility by state and time prior to and after the Medicaid expansion.

See extended abstract

 Presented in Session 107. Causes of Adverse Birth Outcomes