{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"submitter":["Lyu W"],"funding":["NIDCR NIH HHS"],"pagination":["1278-1287"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC8558059"],"repository":["biostudies-literature"],"omics_type":["Unknown"],"volume":["30(9)"],"pubmed_abstract":["<b><i>Objectives:</i></b> This study explores the heterogeneity in effects of the 2014 Affordable Care Act (ACA) Medicaid expansions on insurance coverage, health care access, and health status of low-income women with dependent children by pre-expansion state-level income eligibility. <b><i>Materials and Methods:</i></b> We employ a quasiexperimental difference-in-differences design comparing outcome changes in Medicaid expansion states to nonexpansion states. We estimate effects separately for three groups of expansion states based on pre-expansion (2013) parent income eligibility: low pre-expansion eligibility (<90% of federal poverty level [FPL]), high eligibility (90% to <138% FPL), and full eligibility (≥138% FPL). Study samples include women with dependent children below 138% FPL from the 2011 to 2018 American Community Survey for the insurance outcomes, and from the 2011 to 2018 Behavioral Risk Surveillance System for the access and health outcomes. <b><i>Results:</i></b> There is stark heterogeneity in changes of health insurance and health care access by pre-expansion income eligibility levels. In comparison to Medicaid non-expansion states, there are large increases in insured rate (9 percentage-points) and Medicaid coverage (16 percentage-points) in expansion states with low pre-expansion eligibility. Insurance changes are much smaller in states with high or full pre-expansion eligibility. Changes in access largely mirror those in coverage. There are no significant changes in health status regardless of pre-expansion eligibility. <b><i>Conclusions:</i></b> The ACA Medicaid expansions increased coverage and access for low-income women with dependent children primarily in states with low pre-expansion parent eligibility, and therefore, reduced differences in these outcomes between expansion states."],"journal":["Journal of women's health (2002)"],"pubmed_title":["Heterogeneous Effects of Affordable Care Act Medicaid Expansions Among Women with Dependent Children by State-Level Pre-Expansion Eligibility."],"pmcid":["PMC8558059"],"funding_grant_id":["R03 DE028041"],"pubmed_authors":["Wehby GL","Lyu W"],"additional_accession":[]},"is_claimable":false,"name":"Heterogeneous Effects of Affordable Care Act Medicaid Expansions Among Women with Dependent Children by State-Level Pre-Expansion Eligibility.","description":"<b><i>Objectives:</i></b> This study explores the heterogeneity in effects of the 2014 Affordable Care Act (ACA) Medicaid expansions on insurance coverage, health care access, and health status of low-income women with dependent children by pre-expansion state-level income eligibility. <b><i>Materials and Methods:</i></b> We employ a quasiexperimental difference-in-differences design comparing outcome changes in Medicaid expansion states to nonexpansion states. We estimate effects separately for three groups of expansion states based on pre-expansion (2013) parent income eligibility: low pre-expansion eligibility (<90% of federal poverty level [FPL]), high eligibility (90% to <138% FPL), and full eligibility (≥138% FPL). Study samples include women with dependent children below 138% FPL from the 2011 to 2018 American Community Survey for the insurance outcomes, and from the 2011 to 2018 Behavioral Risk Surveillance System for the access and health outcomes. <b><i>Results:</i></b> There is stark heterogeneity in changes of health insurance and health care access by pre-expansion income eligibility levels. In comparison to Medicaid non-expansion states, there are large increases in insured rate (9 percentage-points) and Medicaid coverage (16 percentage-points) in expansion states with low pre-expansion eligibility. Insurance changes are much smaller in states with high or full pre-expansion eligibility. Changes in access largely mirror those in coverage. There are no significant changes in health status regardless of pre-expansion eligibility. <b><i>Conclusions:</i></b> The ACA Medicaid expansions increased coverage and access for low-income women with dependent children primarily in states with low pre-expansion parent eligibility, and therefore, reduced differences in these outcomes between expansion states.","dates":{"release":"2021-01-01T00:00:00Z","publication":"2021 Sep","modification":"2025-04-18T19:08:04.76Z","creation":"2025-04-07T06:51:01.653Z"},"accession":"S-EPMC8558059","cross_references":{"pubmed":["33555950"],"doi":["10.1089/jwh.2020.8776"]}}