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 the 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 the 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 ...