Oregon's Medicaid expansion improved prenatal care access, birth
outcomes

Date:
January 4, 2021
Source:
Oregon State University
Summary:
A pair of recent studies found that Oregon's Medicaid expansion
in 2014 has led to increased prenatal care among low-income women,
as well as improved health outcomes for newborn babies.



FULL STORY ==========================================================================
A pair of recent studies from Oregon State University found that Oregon's Medicaid expansion in 2014 has led to increased prenatal care among
low-income women, as well as improved health outcomes for newborn babies.


==========================================================================
In the three years after the expansion, one study found that Oregon saw
an almost 2 percentage point increase in first trimester prenatal care utilization, relative to 18% of the pre-expansion population who lacked
any access to prenatal care in the earlier stages of pregnancy.

In the same period, the second study found, Medicaid expansion was
associated with a 29% reduction in low birthweight among babies born to
women on Medicaid, as well as a 23% reduction in preterm births.

Prior to the state's Medicaid expansion as part of the Affordable Care
Act, low-income women who were not otherwise eligible for Medicaid became eligible when they became pregnant. It was estimated that expanding
Medicaid to include everyone earning up to 138% of the federal poverty
level would extend coverage to an additional 77,000 women of childbearing
age.

"This means that women are getting preconception care before they're
pregnant," said lead author Marie Harvey, associate dean for research
in OSU's College of Public Health and Human Sciences. "Then when
they become pregnant, they're more easily able to get prenatal care."
Prior to pregnancy, establishing that connection with a primary care
provider means women are able to receive holistic medical and public
health care to improve their overall well-being.



========================================================================== "It's much broader than just one specific intervention or health
condition," said co-author Susannah Gibbs, a researcher in the College
of Public Health and Human Sciences. "You might think about smoking
cessation or nutrition -- all these things that are kind of an ongoing conversation between a health care provider and someone who might in
the future become pregnant.

"They might receive those interventions that improve their overall health,
and lead them to be in a healthier state when they do become pregnant."
Because the state's Medicaid expansion did not change women's eligibility
for Medicaid during pregnancy and utilization of prenatal services was
already high, the researchers were focused on the impact of greater
continuity of care, where people's access to services was not split into different health states: pregnant versus not-pregnant.

"The almost 2 percentage point increase in prenatal care utilization is encouraging," Harvey said.

The study found almost twice the magnitude of gains in pre-pregnancy
enrollment in Medicaid among Hispanic women compared with non-Hispanic
white women, Gibbs said.

In turn, increased pre-pregnancy enrollment in Medicaid likely contributed
to the positive impacts on low birthweight and preterm births, researchers said, as women with health coverage had greater access to preventive
care and preconception care.

This aligns with the "life course perspective" on health care, Harvey
said, where providing women access to health care early in their lives
leads to better overall health status and thus healthier pregnancies if
they do become pregnant. Babies are then more likely to be born healthy,
and to be connected with health services and primary health care from
an early age as well.

"Once you have people in that medical care system, it is an opportunity
to be connected with those individuals who are in great need of other interventions beyond medical care that reach into the broader public
health space," Gibbs said.

Other OSU co-authors on one or both of the studies were Lisa Oakley,
Shyama Mahakalanda, Jeff Luck and Jangho Yoon.


========================================================================== Story Source: Materials provided by Oregon_State_University. Original
written by Molly Rosbach. Note: Content may be edited for style and
length.


========================================================================== Journal Reference:
1. S. Marie Harvey, Lisa P. Oakley, Susannah E. Gibbs, Shyama
Mahakalanda,
Jeff Luck, Jangho Yoon. Impact of Medicaid expansion in Oregon on
access to prenatal care. Preventive Medicine, 2021; 143: 106360 DOI:
10.1016/ j.ypmed.2020.106360 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2021/01/210104094643.htm

--- up 2 weeks, 6 days, 7 hours, 57 minutes
* Origin: -=> Castle Rock BBS <=- Now Husky HPT Powered! (1337:3/111)