The Affordable Care Act and Access to Care For Reproductive-Aged and Pregnant Women in the United States, 2010-2016

Objectives. To estimate the association between We Affordable Care Act (ACA), health insurance coverage, and access to care among reproductive-aged and pregnant women. Methods. We performed an observational study comparing current insurance type, cost-related barriers to medical care, and no usual source of care among reproductive aged (n =128 352) and pregnant (n = 2179) Female respondents to the National Health Interview Survey in We United States, before (2010-2013) and after (2015-2016) the ACA coverage expansions. Results. Among reproductive-aged women, the ACA was associated with a 7.4 percentage-point decrease in the probability of uninsurance (95% confidence interval [CI] =-8.6,-6.2), a 3.6 percentage-point increase in Medicaid (95% CI = 2.5, 4.7), and a 3.1 percentage-point increase in nongroup private coverage (95% CI = 2.1, 4.1), The ACA was also associated with a 1.5 percentage-point decline in cost-related barriers to medical care (95% CI=-2,6,-0,5) and a 2.4 percentage-point reduction in Lacking a usual source of care (95% CI =-4,5,-0.3). We did not find significant changes in insurance or cost-related barriers to care for pregnant women. Conclusions. The ACA was associated with expanded insurance coverage and improvements in access to care For women of reproductive age, particularly For those with lower incomes.