Fertility of Low Income Women under the Affordable Care Act

The goal of the proposed research is to investigate if low-income women’s reproductive lives have been impacted by the large expansion of Medicaid ushered in as part of the Patient Protection and Affordable Care Act (ACA). Under the ACA, 32 states have expanded Medicaid to low income adults with incomes at or below 138 percent of Federal Poverty Level (FPL). This expansion has increased insurance coverage, improved access to health care, and reduced medically related financial debt. The massive health insurance expansion may also have an important effect on low income women—greater control over their reproductive lives. Yet, how pregnancy and fertility in the United States are influenced by this Medicaid expansion under ACA is not clear, a priori.

 

The main objective of this proposal is to empirically investigate the reproductive outcomes of low income women under the ACA Medicaid expansion. The seed grant will support initial analyses to be included in a subsequent R03 or a R21 grant submission to NICHD or other funding agencies with similar research priorities.

 

The fertility response to the Affordable Care Act (ACA) has important demographic and policy implications. Under the ACA, 32 states have expanded Medicaid to low income adults with incomes at or below 138 percent of Federal Poverty Level (FPL). The massive health insurance expansion may provide women with greater control over their reproductive lives. It is critical to understand whether the ACA expansion is associated with changes in pregnancy and fertility among the key target population of low income women at childbearing age.