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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 4 of 4 Research Studies DisplayedEliason EL, A Spishak-Thomas, Steenland MW
Association of the Affordable Care Act Medicaid expansions with postpartum contraceptive use and early postpartum pregnancy.
The purpose of this study was to assess the relationship of the Affordable Care Act (ACA) Medicaid expansion with postpartum contraception use and pregnancy. The researchers found that Medicaid expansion was associated with a 7.0 percentage point increase in postpartum use of the contraceptive implant and intrauterine device LARC, a 3.1 percentage point decrease in short-acting contraception, and a 3.9 percentage point decrease in non-prescription contraceptive use overall. Increases in LARC use were concentrated among non-Hispanic, White, and Black respondents. Medicaid expansion was associated with a decrease in early postpartum pregnancy only among non-Hispanic Black respondents. The researchers concluded that the ACA Medicaid expansion improved postpartum contraceptive access and led to shifts from methods with a lower upfront out-of-pocket cost for people without insurance towards methods with the higher upfront out-of-pocket cost for people without insurance. These changes suggest that Medicaid expansions increased access to the full range of contraceptive methods.
AHRQ-funded; HS027464; HS000011
Citation: Eliason EL, A Spishak-Thomas, Steenland MW .
Association of the Affordable Care Act Medicaid expansions with postpartum contraceptive use and early postpartum pregnancy.
Contraception 2022 Sep;113:42-48. doi: 10.1016/j.contraception.2022.02.012..
Keywords: Sexual Health, Pregnancy, Maternal Care, Women, Medicaid, Access to Care, Policy
Darney BG, Jacob RL, Hoopes M
Evaluation of Medicaid expansion under the Affordable Care Act and contraceptive care in US community health centers.
This study examined whether Medicaid expansion under the Affordable Care Act increased contraceptive use for women who are underserved in the US health care safety net. The authors used electronic health record (EHR) data from a clinical research network of community health centers across 24 states. The sample included all female patients ages 15 to 44 years at risk for pregnancy with an ambulatory care visit. The study compared receipt of contraception before (2013) vs immediately after (2014) and then in 2016 after a longer period of Medicaid expansion. The sample included 310,132 women from expansion states and 234,508 women from nonexpansion states. There was an associated increase in long-acting reversible contraceptive method prescriptions among women in the expansion states, with adolescents having the largest increase.
AHRQ-funded; HS025155.
Citation: Darney BG, Jacob RL, Hoopes M .
Evaluation of Medicaid expansion under the Affordable Care Act and contraceptive care in US community health centers.
JAMA Netw Open 2020 Jun;3(6):e206874. doi: 10.1001/jamanetworkopen.2020.6874..
Keywords: Medicaid, Women, Policy, Sexual Health
Cottrell E, Darney BG, Marino M
Study protocol: a mixed-methods study of women's healthcare in the safety net after Affordable Care Act implementation - EVERYWOMAN.
In this paper, the authors describe a 5-year, mixed-methods study comparing women's contraceptive, preventive, prenatal and postpartum care before and after ACA implementation and between Medicaid expansion and non-expansion states. They conclude that the findings will be relevant to policy and practice, informing efforts that enhance the provision of timely, evidence-based reproductive care, to improve health outcomes, and to reduce disparities among women. Patient, provider and practice-level interviews will serve to contextualize their findings and to develop subsequent studies and interventions to support women's healthcare provision in community health center settings.
AHRQ-funded; HS025155.
Citation: Cottrell E, Darney BG, Marino M .
Study protocol: a mixed-methods study of women's healthcare in the safety net after Affordable Care Act implementation - EVERYWOMAN.
Health Res Policy Syst 2019 Jun 11;17(1):58. doi: 10.1186/s12961-019-0445-y..
Keywords: Women, Access to Care, Medicaid, Policy, Prevention, Maternal Care, Sexual Health
Moniz MH, Kirch MA, Solway E
Association of access to family planning services with Medicaid expansion among female enrollees in Michigan.
The purpose of this study was to evaluate the association of Medicaid expansion coverage with access to birth control and family planning services among women of reproductive age enrolled in the Michigan expansion plan. The investigators found that one in 3 women of reproductive age reported better ability to access birth control and family planning services through Healthy Michigan Plan compared with before enrollment.
AHRQ-funded; HS025465.
Citation: Moniz MH, Kirch MA, Solway E .
Association of access to family planning services with Medicaid expansion among female enrollees in Michigan.
JAMA Network Open 2018 Aug 31;1(4). doi: 10.1001/jamanetworkopen.2018.1627..
Keywords: Medicaid, Women, Sexual Health, Access to Care, Policy