Funded on December 15, 2018

Recent media reports have highlighted startling trends in U.S. maternal health with stark differences across racial and ethnic groups. Maternal deaths associated with pregnancy and childbirth are high when compared to other developed countries and have increased substantially over the last two decades.

While efforts have been made to improve care during pregnancy, there is growing recognition that access to care prior to pregnancy and after childbirth is critically important for the health of a woman and her infant.

Expanding health insurance coverage for low-income women is an important policy lever to increase access to affordable health care during these critical periods, but there is little existing evidence linking health insurance to improved maternal health outcomes.

This study will clarify the role of insurance by measuring the effects of expanded health insurance coverage for low-income women, and determining whether there are differential effects for mothers with different racial and ethnic backgrounds. The research team will:

  1. Investigate the effect of the ACA Medicaid expansions on health insurance coverage for low-income women before, during, and after pregnancy;
  2. Determine whether there are corresponding changes in the use of health care and health behaviors; and,
  3. Evaluate whether these changes translate into improvements in maternal and newborn health.

Understanding the mechanisms by which expanded health insurance may improve maternal and infant health outcomes is critical to crafting successful policies and interventions that bridge health services and systems to effectively address population disparities.

For more on this topic: 

Related Evidence

  • Published November 1, 2020

    The period before pregnancy is critically important for the health of a woman and her infant, yet not all women have access to health insurance during this time. Rebecca Myerson of the University of Wisconsin-Madison, Samuel Crawford of the University of Southern California, and Laura R. Wherry of New York University evaluated whether increased access to health insurance under the Affordable Care Act (ACA) Medicaid expansions affected ten preconception health indicators, including the prevalence of chronic conditions and health behaviors, birth control use and pregnancy intention, and the receipt of preconception health services.

    View Evidence

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